ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Transthoracic closure of ventricular septal defects guided by transesophageal echocardiography
Huang Jiang-Shan1,2, Sun Kai-Peng1,2, Xu Ning1,2, Zhang Gui-Can1, Chen Qiang1
1Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
2Department of Cardiac Surgery, Fujian Provincial Maternity and Children?s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
DOI : 10.5606/tgkdc.dergisi.2020.18745
Background: This study aims to investigate the effectiveness and safety of transthoracic closure of ventricular septal defects totally guided by transesophageal echocardiography.

Methods: A total of 119 patients (62 males, 57 females; mean age 2.1±5.2 years; range, 11 months to 50 years) who underwent transthoracic closure of ventricular septal defects in our center between April 2017 and November 2018 were included. All patients were evaluated in terms of the diameter and morphological features of ventricular septal defects via transesophageal echocardiography. During the procedure, transthoracic echocardiography was used as the only guiding tool for occluder implantation.

Results: Of the patients, 116 underwent successful transthoracic device closure procedure. Two patients were switched to surgical repair due to new-onset aortic regurgitation in one patient and severe arrhythmias after device release in the other patient. One patient underwent a second operation for occluder migration during the hospital stay. In the first attempt, 106 ventricular septal defect occluders were correctly positioned. Transthoracic echocardiography revealed the insecure position or significant residual shunting in 10 patients. The original device was replaced with an asymmetric device or a more extensive occluder, and satisfactory results were finally obtained. No complications such as new-onset aortic regurgitation, residual shunt, complete heart block, or device dislodgement occurred during follow-up.

Conclusion: Transthoracic closure of ventricular septal defects under the total guidance of transthoracic echocardiography is a safe and effective method.

Keywords : Transesophageal echocardiography, transthoracic device closure, ventricular septal defect
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