关键词: 先天性心脏病, 微创, 封堵术

Abstract: Objective To share our experience of percutaneous or transthoracic closure of atrial septal defect (ASD) and ventricular septal defect (VSD) supported by echocardiography guidance. Methods From December 2010 to September 2019, 54 patients of congenital heart disease (30 cases of isolated atrial septal defect, 24 cases of ventricular septal defect) were treated with surgical operation by occluder under guidance of echocardiography closed without cardiopulmonary bypass. Fourteen cases of ASD were performed device closure through a small right sternal margin thoracotomy incision at the forth intercostal space, 16 cases of ASD underwent percutaneous occlusion surgery, and 24 cases of VSD were closed through small incision under the xiphoid process. Results The operations were successful in the 24 cases of VSD. One of the cases with minimally incision ASD occlusion was displaced 7 hours after operation, the occluder was taken out and ASD was repaired under cardiopulmonary bypass in emergency. There were 13 cases of successful occlusion and 3 cases of failure in percutaneous ASD closure patients. Among three cases, 2 cases underwent ASD closed through transthoracic closure and 1 case underwent open surgery under cardiopulmonary bypass successfully. The 46 cases were followed up for 3-103 months, with an average of (21.3±16.2)months. No occluder displacement, shedding, significant residual shunt were observed. Conclusions Echocardiography-guided percutaneous atrial septal defect and ventricular septal defect is safe and effective without radiation and CPB. Percutaneous closure of atrial septal defect is suitable for children over 3 years. Atrial septal defect and ventricular septal defect occlusion through small thoracic incision is feasible and easy to operate in other healthcare institutions.

Key words: congenital heart disease, minimally invasive surgery, occluder