Comparative Study Of Transthoracic And Percutaneous Closure Of Atrial Septal Defect

Objective: To compare and analyze the advantages and disadvantages of transthoracic and percutaneous closures of atrial septal defect,and to provide a reference for the choice of two minimally invasive approaches.Methods: Patients who underwent surgical closure of atrial septal defect from January 2014 to December 2018 in Cardiovascular Surgery of General Hospital of Ningxia Medical University were reviewed.They were divided into two groups which are the transthoracic group and the percutaneous group.The data of patient were collected in terms of age,weight,length of stay,cost,defect diameter,diameter of occlude,surgical success rate,postoperative complications,echocardiography,electrocardiogram,chest radiograph.Based on the statistical results,the clinical effects of the two different surgical methods were compared and analyzed.Results: Of 315 patients enrolled in this study were 161 cases in the transthoracic group,and 154 cases in the percutaneous group.There were no significant differences of the diameter of atrial septal defect and the diameter of occluder(P> 0.05).There were 3 cases of failure in the transthoracic group and 1 cases of failure in the percutaneous group.There were no statistical differences in the success rate between two groups(P> 0.05).The age and weight in transthoracic group are significantly smaller than in percutaneous group(P <0.01).The cost of hospitalization in the transthoracic group is significantly lower than in the percutaneous group(P <0.05).The time of operation and hospital stay were significantly longer in the transthoracic group than in the percutaneous group(P<0.05).The postoperative complications in transthoracic group were significantly higher than in percutaneous group(P <0.05).As to the postoperative complications,pleural effusion,pneumothorax and pulmonary inflammation in the transthoracic group were significantly higher than those in the percutaneous group.However,postoperatively,there were no significant differences in residual shunt,arrhythmia,pulmonary hypertension and pericardial effusion postoperatively between the two groups.Conclusion: Both of transthoracic and percutaneous approaches for closures of atrial septal defect are effective and safe.Transthoracic approaches can be used with wider range of age and weight.Percutaneous closure are more advantageous comparatively in terms of operation time,postoperative complications,and quick recovery than transthoracic approach.However,transthoracic approach can be carried out easier and with less cost.