• DOI:10.1093/icvts/ivu434
• Corpus ID: 205120679

Results of comparing transthoracic device closure and surgical repair with right infra-axillary thoracotomy for perimembranous ventricular septal defects.

@article{Hu2015ResultsOC,
  title={Results of comparing transthoracic device closure and surgical repair with right infra-axillary thoracotomy for perimembranous ventricular septal defects.},
  author={Yijie Hu and Zhipin Li and Jianming Chen and Fuping Li and Cheng-Cheng Shen and Yi Song and Shulin Zhao and Caijing Peng and Mingxiang Chen and Qianjin Zhong},
  journal={Interactive cardiovascular and thoracic surgery},
  year={2015},
  volume={20 4},
  pages={
          493-8
        }
}

• Yijie Hu, Zhipin Li, +7 authors Qianjin Zhong
• Published 1 April 2015
• Medicine
• Interactive cardiovascular and thoracic surgery

OBJECTIVES
Transthoracic device closure (TTDC) and surgical repair with right infra-axillary thoracotomy (SRRIAT) are two main alternative minimally invasive approaches for restrictive perimembranous ventricular septal defect (VSD); however, few studies have compared them with each other in terms of effectiveness and cost.

METHODS
Patients with perimembranous VSD undergoing TTDC or SRRIAT from January 2012 to July 2013 were reviewed in a comparative investigation between the two procedures.

RESULTS
Success from the procedures was achieved in 30 TTDC (30/33, 91%) and 96 SRRIAT patients (100%). Operation duration in the TTDC group was significantly shorter than that of the SRRIAT group (115.8 ± 43.8 vs 175.6 ± 41.3 min, P < 0.01). The total perioperative drainage, use of red blood cells, mechanical ventilation time, stay in the intensive care unit and hospital stay for the TTDC group were significantly less than those in the SRRIAT group. No deaths or complete atrioventricular block occurred in either group. One SRRIAT patient accepted a second surgery for residual shunt. TTDC costs slightly more than SRRIAT (40270.6 ± 2741.3 renmingbi [RMB] vs 32964.5 ± 8221.6 RMB, P < 0.01).

CONCLUSIONS
Both TTDC and SRRIAT showed excellent outcomes and cosmetic appearance for suitable VSD candidates. Although its costs were higher, TTDC had the advantages over SRRIAT of a short operation duration and intensive care unit stay and fewer days in the hospital.