微创经胸室间隔缺损封堵术在婴幼儿中的应用

目的 评价微创经胸室间隔缺损封堵术治疗3岁以下婴幼儿室间隔缺损的疗效和安全性.方法 2008年10月至2010年4月,共425例3岁以下婴幼儿纳入本研究,其中136例采用微创经胸封堵术,289例采用体外循环下心内直视修补术.记录两组患儿的临床信息及随访资料,采用SPSS 11.5软件统计分析.结果 无死亡病例.封堵组134例成功,2例转为修补术,手术组全部成功,成功率差异无统计学意义.两组患儿术后肺动脉压、心胸比和左室舒张末期内径下降率差异无统计学意义（P＞0.05）,封堵组手术时间、ICU监护时间、术后住院时间、并发症发生率均明显低于手术组（P＜0.001）,封堵组费用高于手术组（P＜0.05）.结论 微创经胸室间隔缺损封堵术治疗3岁以下婴幼儿室间隔缺损操作简单,疗效确切,安全可靠.

Minimally invasive transthoracic ventricular septal defect occlusion application in infants

Objective To evaluate the safety and feasibility of minimally invasive transthoracic ventricu- lar septal defect occlusion application in infants. Methods From October 2008 to April 2010, 425 infants with perimembranous ventricular septal defect were enrolled in our study. Among them, 136 patients were treated by minimally invasive transthoracic ventricular device occlusion and 289 patients were treated by surgical repair. Clinical data were measured and then analyzed by SPSS 11.5. Results There was no death in either group. The success rate was similar in the 2 groups： 134/136 patients in the device group versus 289/289 patients in the surgical group. Both groups were similarly effective in reducing right pulmonary arterial pressure, cardiac function and left ventricular end-diastolic dimension. Procedure time, intensive care unit stay and inpatient stay was shorter in the device group. The device group had lower complication rate, but higher total cost. Conclusion Minimally invasive transthoracic ventricular device closure of perimembranous ventricular septal defects in infants is safe and feasible.