Kết quả phẫu thuật tim hở ít xâm lấn vá thông liên thất qua đường ngực phải ở trẻ em tại Trung tâm Tim mạch, Bệnh viện E

Abstract

Objectives: To evaluate indications, techniques and early outcomes of minimally invasive ventrical septal defect (VSD) surgical closure via right anterolateral thoracotomy at the cardiovascular center of E hospital.

Methods: This is a prospective and retrospective descriptive type of study. 106 patients were diagnosed with VSD and underwent the minimally intensive operation through right anterolateral thoracotomy at the cardiovascular center of E hospital from June 2018 to March 2021.

Results: 106 patients in the study, mean  age  was  1,1 +1,7 years, mean body weight was 7,6 ± 4,1  kg, the boy:girl ratio was 1,3. 102 patients (96,2%) were suffered from grade I, II  heart failure before undergoing surgical repair. The mean VSD diameter was 7,2 ± 2,4 mm (3-15 mm). Perimembranous septum, infundibular septum, inlet septum and trabecular septum accounted for 68%, 28,3%, 2,8% and 1,9%, respectively. The duration of cardiopulmonary bypass was 70,2 ± 28 minutes, the aortic cross-clamping time  was 45,7 ± 26  minutes, the length of skin incision was 4,18 ± 0,5cm. Postoperative mechanical ventilation time was 15,7 ± 10,8 hours, the duration of intensive care was 3,3 ± 1,1 days  and length of hospital stay was 12,4 ± 5,1 days. Postoperative residual shunt accounted for 5,7%. Follow- up examination after the surgery from 3 to 12 months observed 94,6% NYHA I, 89,1% of these patients having normal pulmonary artery pressure and 95,7% of these patients satisfied results of this method.

Conclusion: Repair of ventricular septal defect through right anterolateral thoracotomy provided children with considerable results and significant benefits including early recovery, declining the risk of sternal wound infection, favorable cosmetic results with small surgical scars… The majority of the patients completely satisfied the type of operation.