Doubly committed ventricular septal defect: Is it safe to perform surgical closure through the pulmonary trunk approached by right vertical axillary thoracotomy?
| Autor: | Nguyen UH; Department of Surgery, Hanoi Medical University, Hanoi, Vietnam., Nguyen TLT; Department of Cardiovascular Surgery, Vietnam National Children's Hospital, Hanoi, Vietnam., Kotani Y; Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan., Nguyen MT; Department of Cardiovascular Surgery, Vietnam National Children's Hospital, Hanoi, Vietnam., Mai DD; Department of Cardiovascular Surgery, Vietnam National Children's Hospital, Hanoi, Vietnam., Nguyen VAT; Department of Cardiology, Vietnam National Children's Hospital, Hanoi, Vietnam., Nguyen NT; Department of Thoracic and Cardiovascular Surgery, Thanh Hoa Children Hospital, Thanh Hoa, Vietnam. |
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| Jazyk: | angličtina |
| Zdroj: | JTCVS open [JTCVS Open] 2023 Jul 06; Vol. 15, pp. 368-373. Date of Electronic Publication: 2023 Jul 06 (Print Publication: 2023). |
| DOI: | 10.1016/j.xjon.2023.06.012 |
| Abstrakt: | Objective: This study investigated the safety of performing surgical repair for doubly committed ventricular septal defects by right vertical infra-axillary minithoracotomy (RVIAT). Methods: A retrospective comparative study was performed to evaluate the outcomes of patients who underwent doubly committed ventricular septal defects closure from January 2019 to May 2022. Seventy-four patients were enrolled in the study and treated with either the median sternotomy approach (MSA: n = 37) or the RVIAT approach (RVIAT: n = 37). Results: The median weight and age in the MSA group were significantly lower than those in the RVIAT group (MSA: 6.0 kg [interquartile range] (IQR), 5.2 to 8.7 kg] vs RVIAT: 7.5 kg [IQR, 5.6-14 kg]; P = .034 and MSA: 4.9 months [IQR, 3.6-9.4 month] vs 9.6 months [IQR, 5.0-60.4 months]; P = .0084). No patients died, and no patients in the RVIAT group required conversion to the MSA approach. The mean prebypass surgical time was longer in the RVIAT group (36.1 ± 8.2 minutes vs 31.8 ± 5.6 minutes; P = .03). There were no significant differences between the 2 groups in cardiopulmonary bypass time, aortic crossclamp time, or operation time. Significantly shorter ventilation times were observed in the RVIAT group (11.9 ± 8.2 hours vs 15.4 ± 6.3 hours; P = .006). Conclusions: Closure of doubly committed ventricular septal defects through the pulmonary trunk by the RVIAT approach is feasible and safe, and does not increase the risk of bypass-related complications. (© 2023 The Author(s).) |
| Databáze: | MEDLINE |
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