Value of transesophageal echocardiography in device closure of
perimembranous ventricular septal defects in children via an
ultraminimal intercostal incision
Abstract
Object: Investigate the value of transesophageal echocardiography (TEE)
in perimembranous ventricular septal defect (PmVSD) closure via a left
parasternal ultra‐minimal trans intercostal incision in children.
Methods: From January 2015 and December 2020, 212 children with PmVSD
were performed device occlusion via an ultraminimal intercostal
incision. TEE is used throughout the perioperative period, including TEE
assessment, TEE-guided localization of the puncture site, TEE guidance.
All patients were followed up using transthoracic echocardiography for
over 6 months. Results: A total of 207 cases successfully occluded, the
successful rate was 97. 64%. one hundred and forty-five patients had
single orifice, and 62 patients had multiple orifices in the AMS. During
the operation, the surgeon readjusted the device or replaced the larger
device in 17 cases. After operation, there were 19 cases of slight
residual shunts, 13 cases of pericardial effusion and 4 cases of pleural
effusion. And all were back to normal during the 4- month follow-up
period. Mild mitral regurgitation was presented in 1 patient and
remained the same during the follow-up period. No other complications
were found. Conclusions: TEE was used to evaluate and determine the
defect in PmVSDs with an concentric occluder via a left parasternal
ultra‐minimal trans intercostal incision. TEE guidance and immediate
postoperative efficacy evaluation are of great value, which can
effectively guide the treatment of PmVSD occlusion.