Abstract
ObjectivesTo summarize and analyze the clinical characteristics of postoperative complications after minimally invasive closure of transthoracic ventricular septal defect, and to explore the risk factors for its occurrence.MethodsRetrospectively analyzed the clinical data of 209 patients underwent transthoracic ventricular septal defect closure performed in the Department of Cardiothoracic Surgery, Children’s Hospital of Chongqing Medical University from January 2018 to January 2020, obtained relevant clinical data from the electronic medical record system and summarized their postoperative complications. And used univariate logistics regression and multivariate logistics regression to analyze the risk factors of its occurrence.ResultsThe postoperative hospital stay of 27 patients was longer than 9 days. Residual shunt occurred in 33 patients recently after operation. One patient underwent surgical treatment again because of mechanical hemolysis after the operation. Two patients were re-operated 1 month and 10 months after surgery because of persistent moderate to severe aortic regurgitation. After surgery, 3 patients underwent pericardiocentesis due to a large amount of pericardial effusion, and 2 patients developed a new atrioventricular block after the operation. No other serious adverse events occurred. Multivariate logistic regression analysis showed that the size of VSD defect (OR: 1.494, 95% Cl: 1.108–2.013, P value: 0.008) was related to long postoperative hospitalization. The residual shunt is related to the size of the occluder (OR: 1.452, 95%Cl: 1.164–1.810, P value: 0.001). In the univariate logistics regression analysis, no risk factors related to serious adverse events were found.ConclusionsThe minimally invasive closure of transthoracic ventricular septal defect is very effective, with no mortality and low incidence of serious adverse events after surgery. The size of the defect is related to the long postoperative hospitalization, and the size of the occluder is related to the residual shunt in the early postoperative period. No risk factors related to the occurrence of serious adverse events after the operation were found.
Highlights
Ventricular septal defect (VSD) is one of the most common congenital heart diseases, accounting for about 20% of congenital heart disease [1]
Patients were selected according to the following indications: All patients were diagnosed by transthoracic echocardiography before surgery, VSD size was 3-8 mm, clear left to right shunt and with or without mild to moderate pulmonary hypertension
The average postoperative hospital stay was 7.88 ± 2.93 days, which was related to our hospital’s clinical path and postoperative health management. For those children whose hospital stay was longer than 9 days, these patients had complications after surgery, which we defined as postoperative Long hospital stay
Summary
Ventricular septal defect (VSD) is one of the most common congenital heart diseases, accounting for about 20% of congenital heart disease [1]. Minimally invasive closure of transthoracic ventricular septal defect has been widely used in China. This procedure is suitable for almost all patients. It does not require cardiopulmonary bypass, small surgical incisions, quick postoperative recovery, no X-ray exposure and wider indications than interventional closure, which has been increasingly recognized by clinicians and patients/parents [2, 3]. No studies summarized the postoperative complications and corresponding risk factors of this operation. The purpose of this study was to evaluate the complications of minimally invasive closure of transthoracic ventricular septal defect in a short-term single-center cohort and to determine the corresponding risk factors
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