Open-Chest Device Closure for the Minimally Invasive Management of Atrial Septal Defect in Young Children

Authors

  • Hao Zhang
  • Shou-jun Li
  • Yong-qing Li
  • Hao Wang
  • Sheng-shou Hu

DOI:

https://doi.org/10.1532/HSF98.20061179

Abstract

Background. We integrated a catheter-based device and minimally invasive surgical techniques for the treatment of atrial septal defect for children younger than 2 years old.

Methods. Forty-three patients were divided into 3 groups: group A underwent open-chest device closure with a right lateral thoracotomy (n = 12), group B underwent openheart repair with a right lateral thoracotomy and cardiopulmonary bypass (n = 11), and group C underwent open-heart repair with a median thoracotomy and cardiopulmonary bypass (n = 20).

Results. Group A had the lowest weight (9.25 ± 1.3 kg) and smallest defect size (10.25 ± 3.9 mm). In group A, 2 patients had to be transitioned to open-heart repair after unsuccessful occlusion. Compared with the open-heart groups, the device group had a shorter total operation time (111 ± 39 minutes), required the minimum amount of blood products (39 ± 38 mL), and had a smaller amount of pleural drainage in the first 12 hours after the procedure (29 ± 12 mL). All patients were discharged. The right ventricular end-diastolic diameter reduced significantly after the repair; furthermore, there was no difference in the size of reduction. However, the device group had the highest medical costs (30,639 ± 3831 Chinese yuan). During the follow-up, there were no occluder-related complications observed in Group A, and there were no residual shunts or arrhythmia observed in the groups.

Conclusions. The open-chest device closure was safely performed as a supplement for percutaneous treatment for young children.

References

Karski JK, Balatbat JT. 2003. Blood conservation strategies in cardiac surgery. Semin Cardiothorac Vascul Anesth 7:175-88.nLammers A, Hager A, Eicken A, et al. 2005. Need for closure of secundum atrial septal defect in infancy. J Thorac Cardiovasc Surg 129:1353-7.nLiang T, Xiangjun Z, Xiaojin M, et al. 2006. New minimally invasive technique to occlude secundum atrial septal defect in 53 patients. Ann Thorac Surg 81:1417-9.nLiu YL, Zhang HJ, Sun HS, et al. 2000. Repair of cardiac defects through a shorter right lateral thoracotomy in children. Ann Thorac Surg 70:738-41.nThanopoluos BD, Laskari CV, Tsaousis GS, et al. 1998. Closure of atrial septal defects with the Amplatzer occlusion device: preliminary results. J Am Coll Cardiol 31:1110-6.nVida VL, Barnoya J, O'Connell M, et al. 2006. Surgical versus percutaneous occlusion of ostium secundum atrial septal defects: results and cost-effective considerations in a low-income country. J Am Coll Cardiol 47:326-31.n

Published

2007-02-21

How to Cite

Zhang, H., Li, S.- jun, Li, Y.- qing, Wang, H., & Hu, S.- shou. (2007). Open-Chest Device Closure for the Minimally Invasive Management of Atrial Septal Defect in Young Children. The Heart Surgery Forum, 10(2), E125-E128. https://doi.org/10.1532/HSF98.20061179

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