Application of the children patients less than 15 kg who received ventricular septal defect repairing via Vertical right axillary mini-thoracotomy approach
Li Xinya1, Zhou Hong2, Jiang Yiyao3, Li Jian'an1, Lei Hong1, Ge Jianjun1
1Department of Cardiac Surgery, the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital), Hefei 230001, China; 2Department of the One-Day Ward, the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital), Hefei 230001, China, 3Department of Cardiac Surgery, Tianjin First Central Hospital, Tianjin 300000, China
Abstract：Objective To investigate the effect of via vertical right axillary mini-thoracotomy (VRAMT )approach in repairing ventricular septal defect (VSD) in the children patients weighing less than 15 kg.Methods This was a retrospective cohort study that included 84 children patients (41 males and 43 females) aged 3-34 (15.17±7.26)months old, weighing 5-15 (9.64±2.64) kg. The children diagnosed with VSD by echocardiography from January 2017 to November 2019 in the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed. They were categorized into two different groups according to the surgical approach used on them, namely, VRAMT group (38 cases) and MS group (46 cases). Patients in the VRAMT group received VSD repair via VRAMT, whereas the MS group received VSD repair via median sternotomy. The aortic cross-clamp time, cardiopulmonary bypass (CPB) time, intensive care unit (ICU) duration, ventilation time, length of hospital stays, incidence of residual shunt, Ⅲ degree atrioventricular block , redo-surgery, and cardiac functional grading at 6 months after surgery were compared between the two groups.Results The baseline characters included age, gender, weight, style and diameter of defect, differential pressure across the defect, ejection fraction between the two groups (all P values＞0.05). Patients in the two groups all had a successful surgery. No patients had Ⅲ degree atrioventricular block and redo-surgery. All patients were followed up 6 months after the operation. Compared with the MS group, i.e., (39.23±9.86) h and (17.41±4.55) d, the patients in the VRAMT group, i.e., (24.23±5.48) h and (15.37±3.91) d, had shorter ICU duration and hospital stays (24.23±5.48) h vs. (39.23±9.86) h and (15.37±3.91) d vs. (17.41±4.55) d, respectively(all P values<0.05). Age, gender, weight, VSD style and diameter, differential pressure, left ventricular ejection fraction (LVEF), suture method, CPB time, aortic cross-clamp time, ventilation time, incidence of residual shunt, and NYHA 6 months after surgery did not significantly differ between the two groups (all P values＞0.05).Conclusions For children patients who received VSD repairing and weighed less than 15 kg, the VRAMT approach was obvious clinical advantages compared with the median sternotomy approach and deserves more clinical attention.
李新亚, 周红, 姜亦瑶, 李建安, 雷虹, 葛建军. 右进胸垂直小切口在体质量15 kg以下患儿室间隔缺损修补术中的应用[J]. 中华解剖与临床杂志, 2020, 25(5): 516-519.
Li Xinya, Zhou Hong, Jiang Yiyao, Li Jian'an, Lei Hong, Ge Jianjun. Application of the children patients less than 15 kg who received ventricular septal defect repairing via Vertical right axillary mini-thoracotomy approach. Chinese Journal of Anatomy and Clinics, 2020, 25(5): 516-519.
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2020, Vol. 25 
