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Date Published: 31/07/2024
Abstract Views: 49
Views PDF: 11
DOI: https://doi.org/10.47972/vjcts.v47i.1159
Issue
Vol. 47
Section
Research Article
How to Cite
Pham, T. A., Pham, T. M. H., Vu, V. B., & Nguyen, T. T. (2024). Evaluate the results of anesthesia and resuscitation of minimally invasive surgery for pediatric patients with ventricular septal defect at Cardiovascular Center, E hospital in 2022. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 47, 75-82. https://doi.org/10.47972/vjcts.v47i.1159

Evaluate the results of anesthesia and resuscitation of minimally invasive surgery for pediatric patients with ventricular septal defect at Cardiovascular Center, E hospital in 2022

Tuan Anh Pham1, Thi Minh Hue Pham1, Van Ba Vu1, Tran Thuy Nguyen1,
1 Cardiovascular Center, E Hospital

Main Article Content

Abstract

Objective: Minimally invasive surgery has recently been implemented safely and effectively on children. The study aimed to evaluate the results of anesthesia and resuscitation in pediatric patients with ventricular septal defects (VSD) undergoing minimally invasive surgery.


Methods: A cross-sectional study from January 1, 2021 to June 30, 2022 on 65 patients underwent minimally invasive surgery to repair ventricular septal defect, at Cardiovascular Center, E Hospital.


Result: A toltal of 65 children aged from 1 month to 34 months, mean weight of 9.0 ± 6.3kg, mean height of 73.6 ± 22.1cm, with main clinical symptoms of slow weight gain (62.5%) and grade I heart failure (87.7%). The most common VSD location was perimembranous VSD (67.7%) with an mean size of 5.7±2.6 mm. The mean surgical time was 175 minutes with cardiopulmonary bypass time and aortic cross-clamp time of 77.5 and 53.0 minutes, respectively. Postoperative hemodynamic parameters changed statistically significantly compared to pre-operation: blood pressure decreased, heart rate increased, lactate level  increased, P/F ratio decreased, blood potassium level decreased. The patient mainly needed to use 1 vasopressor, 1 type of sedative analgesic, continuous diuresis, and prophylactic antibiotics with a vasopressor withdrawal time of 34.2 hours, a sedation withdrawal time of 13.35 hours, and a sedative withdrawal time of 13.35 hours. Intubation time of 20.8 hours (minimum 2 hours) and length of stay ICU was 3.8 days. Postoperative complications were low, mainly pneumonia (9.2%) and residual shunt (9.2%), and no death was observed.


Conclusion: Minimally invasive ventricular septal defect surgery showed that the anesthesia and surgical process did not change much, with relatively fast post-operative recovery results, short medication time, quick recovery, and no recording severe complications.

Article Details

Keywords

ventricular septal defect, minimally invasive surgery, anesthesia

References

1. Viet NL. Ventricular Septal Defect. Practicing cardiology. 1996:120-30.
2. Fyler D.C JKJL. Ventricular septal defects. Nadas pediatric cardiology. 2006:435-7.
3. Ikawa S, Shimazaki Y, Nakano S, Kobayashi J, Matsuda H, Kawashima Y. Pulmonary vascular resistance during exercise late after repair of large ventricular septal defects. Relation to age at the time of repair. J Thorac Cardiovasc Surg. 1995;109(6):1218-24.
4. Aydemir NA, Harmandar B, Karaci AR, Sasmazel A, Bolukcu A, Saritas T, et al. Results for surgical closure of isolated ventricular septal defects in patients under one year of age. J Card Surg. 2013;28(2):174-9.
5. Ergün S, Genç SB, Yildiz O, Öztürk E, Kafalı HC, Ayyıldız P, Haydin S. Risk Factors for Major Adverse Events after Surgical Closure of Ventricular Septal Defect in Patients Less than 1 Year of Age: A Single-Center Retrospective. Braz J Cardiovasc Surg. 2019;34(3):335-43.
6. Jortveit J, Leirgul E, Eskedal L, Greve G, Fomina T, Døhlen G, et al. Mortality and complications in 3495 children with isolated ventricular septal defects. Arch Dis Child. 2016;101(9):808-13.
7. Liu H, Lu FX, Zhou J, Yan F, Qian SC, Li XY, et al. Minimally invasive perventricular versus open surgical ventricular septal defect closure in infants and children: a randomised clinical trial. Heart. 2018;104(24):2035-43.
8. Dat TT, Tien ĐA, Thành LN, Phong NB, Minh LN. Results of minimally invasive open heart surgery to repair ventricular septal defect through the right chest in children at the Cardiovascular Center, E hospital. Vietnam Journal of Cardiovascular and Thoracic Surgery. 2021;34:79-87.
9. Dixit S, Sharma A, Suthar J, Watti V, Sharma M. Repair of ventricular septal defect through anterolateral thoracotomy with central cannulation: our experience. Indian J Thorac Cardiovasc Surg. 2020;36(5):476-82.
10. Liu H, Wang Z, Xia J, Hu R, Wu Z, Hu X, Ren W. Evaluation of Different Minimally Invasive Techniques in Surgical Treatment for Ventricular Septal Defect. Heart Lung Circ. 2018;27(3):365-70.
11. Schipper M, Slieker MG, Schoof PH, Breur JM. Surgical Repair of Ventricular Septal Defect; Contemporary Results and Risk Factors for a Complicated Course. Pediatr Cardiol. 2017;38(2):264-70.
12. Braun SR, Birnbaum ML, Chopra PS. Pre- and postoperative pulmonary function abnormalities in coronary artery revascularization surgery. Chest. 1978;73(3):316-20.
13. Singh NP, Vargas FS, Cukier A, Terra-Filho M, Teixeira LR, Light RW. Arterial blood gases after coronary artery bypass surgery. Chest. 1992;102(5):1337-41.
14. Pramanik S, Harley KN, Jambhulkar RK, Das RK, Sathe JS. Investigating pre and post-operative blood gases and serum electrolyte in patients undergoing coronary artery bypass surgery (CABG). International Journal of Clinical Biochemistry and Research. 2017;4:149-53.
15. Hong ZN, Chen Q, Lin ZW, Zhang GC, Chen LW, Zhang QL, Cao H. Surgical repair via submammary thoracotomy, right axillary thoracotomy and median sternotomy for ventricular septal defects. J Cardiothorac Surg. 2018;13(1):47.
16. Fraser CD, 3rd, Ravekes W, Thibault D, Scully B, Chiswell K, Giuliano K, et al. Diaphragm Paralysis After Pediatric Cardiac Surgery: An STS Congenital Heart Surgery Database Study. Ann Thorac Surg. 2021;112(1):139-46.
17. Siehr SL, Hanley FL, Reddy VM, Miyake CY, Dubin AM. Incidence and risk factors of complete atrioventricular block after operative ventricular septal defect repair. Congenit Heart Dis. 2014;9(3):211-5.