Comparision On Treatment Of Perimembranous Ventricular Septal Defects By Mini-invasive Perventricular Device Closure And Interventional Operation

Objective The comparative evaluation of minimally invasive perventricular deviceclosure of ventricular septal defects (VSD) and percutaneous interventional operationin treatment of perimembranous VSD are performed, which to provide a basis forclinical optimization.Methods From Jan2010to July2012,45patients with perimembranous VSD weretreated by percutaneous device closure (group A), while81patients the same age bymini-invasive perventricular device closure (group B). The efficiency, complications,hospital stay and cost of both operations were compared.Results There were no statistical differences in the rate of initial success betweengroups (97.8%VS100%，P>0.05). The overall incidence of complications of group A(6.7%) was lower than that of group B (49.4%)(P<0.05): In group A, one patient hadserious residual shunt and hemolysis after closure and was converted to open heartrepair. In addition, ransient complete atrioventricular block occurred in1patient, andaggravating mitral regurgitation happen to another. The complications in group Bincluded: worsening valvular regurgitation in2patients, incision infection in3patients, one of them developed into sepsis, acute laryngeal edema requiredreintubation in1patient, pulmonary infection in34patients. The operating time, thehospital stay and the total cost of group A were obviously less than those of group B(P<0.05). Conclusion The mini-invasive perventricular device closure and the interventionaloperation are all effective for treatment of perimembranous VSD. For most ofselective patients, percutaneous device closure should be the first choice of treatment.