| [Purpose]Minimally invasive transthoracic device closure(MITDC)of ventricular septal defects(VSDs)is increasingly being performed;however,concerns remain about the permanent implantation of the device and severe complications,such as valve regurgitation and conduction block.We retrospectively reviewed 187 children who underwent MITDC at our centre and analysed an average of 3.18±1.37 years of followup results.[Methods and Results]From December 2010 to April 2018,221 children underwent MITDC,of which 187(mean age,1.727±1.47 years;mean body weight,10.5±4.36 kg)completed followup,while 34 were lost to follow-up.A total of 181 were successfully treated,and 6 experienced treatment failure.With successful treatment,no mortality occurred,and there was no device dislocation,aortic regurgitation,embolization,haemolysis,vasoactive drug use or blood transfusion.Six patients underwent immediate conventional repair during the operation,and 4 patients underwent conventional repair after MITDC.2 of whom were serious arrhythmia,while the other was endocarditis.One minor residual shunt was performed for conventional surgical closure because of the parent’s request.Six patients with incomplete right branch bundle block were identified in the follow-up period,and 2 of them recovered in the first 3-month followup period.None of the patients needed pacemaker implantation for conduction block.The left atrium(LA)and left ventricular diastolic dimension(LVDd)were significantly decreased after the procedure(P value<0.01)on the third day after treatment.Newly developed tricuspid regurgitation was observed in 30 patients;none of them presented serious regurgitation to the end of follow-up.Chi-Square Test analysis indicated that sex,age,weight,type and size of ventricular septal defect,and the period of operation were not influence factors for postoperative valve regurgitation and arrhythmia.[Conclusion]MITDC is a safe,aesthetically pleasing alternative treatment;however,conduction block and valve regurgitation are still concerns that need additional follow-up. |
