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儿童室间隔缺损封堵术:杂交手术与传统手术方法对比

Hybrid versus traditional method closure of ventricular septal defects in children.

作者信息

Adilbekova Akkerbez, Marassulov Shukhrat, Baigenzhin Abay, Kozhakhmetov Saken, Nurkeyev Bakhytzhan, Kerimkulov Amangeldy, Murzabayeva Saniya, Maiorov Rinat, Kenzhebayeva Arailym

机构信息

Department of Pediatric Cardiac Surgery, National Scientific Medical Center, Astana City, Republic of Kazakhstan.

Department of Surgical Diseases Named Tsoi, Аstana Medical University, Astana City, Republic of Kazakhstan.

出版信息

JTCVS Tech. 2024 Jan 22;24:137-144. doi: 10.1016/j.xjtc.2024.01.015. eCollection 2024 Apr.

Abstract

OBJECTIVE

The aim of our study was to evaluate the safety and effectiveness of the hybrid method off-pump for closure of isolated ventricular septal defect (VSD) compared with the traditional method of on-pump of children.

METHODS

This research was a retrospective cohort study. Data were collected from 500 patients with isolated VSD (or residual VSD after a previous repair) who underwent surgery at the National Scientific Medical Center from May 2016 to December 2020. Patients were operated with 1 of 2 methods of surgery: the traditional method of on-pump or the hybrid method of off-pump. This study assessed the safety and efficacy of the hybrid method by comparing it with the traditional method for the treatment of patients with isolated VSD.

RESULTS

The procedural success rate reached 93.2% in the hybrid method, with a 6.4% conversion rate to the traditional method and 0.4% hospital mortality. The mean operation time was 84 minutes (31; 160 minutes) in the hybrid group (n = 250) and 168 minutes (70; 300 minutes) in the traditional group (n = 250) ( = .000). Hospital mortality was 0.43% in the first group and 1.5% in the second group ( = .000).

CONCLUSIONS

The hybrid method of VSD closure is safe and effective in a selected group of patients. The advantages of the hybrid method are improved cosmetics and shorter operation time and overall hospital stay.

摘要

目的

我们研究的目的是评估与传统体外循环方法相比,非体外循环杂交方法闭合小儿孤立性室间隔缺损(VSD)的安全性和有效性。

方法

本研究为回顾性队列研究。收集了2016年5月至2020年12月在国家科学医学中心接受手术的500例孤立性VSD(或既往修补术后残余VSD)患者的数据。患者采用以下两种手术方法之一进行手术:传统体外循环方法或非体外循环杂交方法。本研究通过将杂交方法与传统方法治疗孤立性VSD患者进行比较,评估其安全性和有效性。

结果

杂交方法的手术成功率达到93.2%,转为传统方法的转化率为6.4%,住院死亡率为0.4%。杂交组(n = 250)的平均手术时间为84分钟(31;160分钟),传统组(n = 250)为168分钟(70;300分钟)(P = .000)。第一组的住院死亡率为0.43%,第二组为1.5%(P = .000)。

结论

VSD闭合的杂交方法在特定患者群体中是安全有效的。杂交方法的优点是美容效果更好、手术时间更短以及总体住院时间更短。

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