Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, 400014, No.136, Zhongshan 2nd Road, Yuzhong Dis, P.R. China.
Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders (Chongqing); China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing, P.R. China.
J Cardiothorac Surg. 2021 Mar 19;16(1):30. doi: 10.1186/s13019-021-01415-z.
To summarize and analyze the clinical characteristics of postoperative complications after minimally invasive closure of transthoracic ventricular septal defect, and to explore the risk factors for its occurrence.
Retrospectively analyzed the clinical data of 209 patients underwent transthoracic ventricular septal defect closure performed in the Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University from January 2018 to January 2020, obtained relevant clinical data from the electronic medical record system and summarized their postoperative complications. And used univariate logistics regression and multivariate logistics regression to analyze the risk factors of its occurrence.
The postoperative hospital stay of 27 patients was longer than 9 days. Residual shunt occurred in 33 patients recently after operation. One patient underwent surgical treatment again because of mechanical hemolysis after the operation. Two patients were re-operated 1 month and 10 months after surgery because of persistent moderate to severe aortic regurgitation. After surgery, 3 patients underwent pericardiocentesis due to a large amount of pericardial effusion, and 2 patients developed a new atrioventricular block after the operation. No other serious adverse events occurred. Multivariate logistic regression analysis showed that the size of VSD defect (OR: 1.494, 95% Cl: 1.108-2.013, P value: 0.008) was related to long postoperative hospitalization. The residual shunt is related to the size of the occluder (OR: 1.452, 95%Cl: 1.164-1.810, P value: 0.001). In the univariate logistics regression analysis, no risk factors related to serious adverse events were found.
The minimally invasive closure of transthoracic ventricular septal defect is very effective, with no mortality and low incidence of serious adverse events after surgery. The size of the defect is related to the long postoperative hospitalization, and the size of the occluder is related to the residual shunt in the early postoperative period. No risk factors related to the occurrence of serious adverse events after the operation were found.
总结分析经胸微创封堵术治疗室间隔缺损术后并发症的临床特点，并探讨其发生的危险因素。
回顾性分析 2018 年 1 月至 2020 年 1 月重庆医科大学附属儿童医院心胸外科行经胸微创室间隔缺损封堵术的 209 例患者的临床资料，从电子病历系统中获取相关临床资料，并对其术后并发症进行总结。采用单因素 logistic 回归和多因素 logistic 回归分析其发生的危险因素。
27 例患者术后住院时间长于 9 d。术后近期残余分流 33 例。1 例术后因机械性溶血再次手术治疗。2 例分别于术后 1 个月和 10 个月因持续性中重度主动脉瓣反流再次手术。术后 3 例因大量心包积液行心包穿刺，2 例术后新发完全性房室传导阻滞。无其他严重不良事件发生。多因素 logistic 回归分析显示，VSD 缺损大小（OR：1.494，95%CI：1.108-2.013，P 值：0.008）与术后住院时间延长有关。残余分流与封堵器大小有关（OR：1.452，95%Cl：1.164-1.810，P 值：0.001）。单因素 logistic 回归分析未发现与严重不良事件相关的危险因素。
经胸微创封堵术治疗室间隔缺损效果确切，术后无死亡，严重不良事件发生率低。缺损大小与术后住院时间延长有关，封堵器大小与术后早期残余分流有关。未发现与术后严重不良事件发生相关的危险因素。
