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Comparative Study
. 2021 Jun 7;16(1):165.
doi: 10.1186/s13019-021-01543-6.

Comparison of the clinical effect between the lower sternal incision and the left parasternal fourth intercostal incision in the transthoracic closure of ventricular septal defect

Jun Ma #  1 , Wenlin Shangguan #  2   3 , Liang-Wan Chen  2   3 , Dong-Shan Liao  4
Affiliations
Comparative Study

Comparison of the clinical effect between the lower sternal incision and the left parasternal fourth intercostal incision in the transthoracic closure of ventricular septal defect

Jun Ma et al. J Cardiothorac Surg. .

Abstract

Background: To analyze the clinical effect of two different ways of minimally invasive transthoracic closure in children with ventricular septal defect (VSD).

Methods: From January 2015 to July 2019, 294 children with VSD were enrolled in the Fujian Medical University Union Hospital. Patients were divided into two groups - those who underwent VSD closure through the left sternal fourth intercostal incision (group A: n = 95) and the lower sternal incision (group B: n = 129).

Results: The operation time, bleeding volume, postoperative mechanical ventilation time, postoperative intensive care unit (ICU) monitoring time, postoperative hospitalization time and complication rate in group A were significantly lower than those in group B (P < 0.05). There was no significant difference between the two groups in the operation success rate, mechanical ventilation time and total hospitalization cost (P > 0.05).

Conclusion: The transthoracic closure of ventricular septal defect through the left sternal fourth intercostal incision is feasible, safe, cosmetic, and worth popularizing.

Keywords: Cardiac intervention; Congenital heart diseases; Ventricular septal defect.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
left sternal fourth intercostal incision
Fig. 2
Fig. 2
lower sternal incision
Fig. 3
Fig. 3
Blocking operation diagram under TEE. ①:Evaluate the VSD size under TEE and select the appropriate occluder.②:The guide wire passed through the ventricular septal defect through the trocar guided by ultrasound.③:Release the left ventricle occlusion umbrella and pull it close to the left ventricle④:There was no significant residual shunt in the TEE assessment
See this image and copyright information in PMC

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