Comparison of transcatheter closure, mini-invasive closure, and open-heart surgical repair for treatment of perimembranous ventricular septal defects in children

Yi, Kang; You, Tao; Ding, Zhaohong; Hou, Xiaodong; Liu, Xing-Guang; Wang, Xin-Kuan; Tian, Jinhui

doi:10.1097/md.0000000000012583

Cited by 15 publications

(13 citation statements)

References 26 publications

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“…Recently, the emergence of transcatheter closure of pmVSD has been attracting considerable attention. Intervention closure offered several such as advantages rapid recovery, less trauma, less need for blood transfusion, shorter duration of hospital stay, and fewer complications [21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of transcatheter versus surgical closure of perimembranous ventricular septal defect in pediatric patients: A systematic review and meta-analysis

El-Kadeem¹,

Nemr²,

Amrousy³

et al. 2019

Journal of the Saudi Heart Association

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ObjectivePerimembranous ventricular septal defect (pmVSD) is a common congenital heart disease (CHD) usually treated with either catheter or surgical closure. Superiority of one procedure over the other in children is still a matter of debate. We performed this meta-analysis to compare the clinical outcomes and cost of transcatheter and surgical closure of pmVSD in children.Materials and methodsWe searched seven databases (MEDLINE, PubMed, EMBASE, Google Scholar, CENTRAL, CINHAL, and Cochrane library) and literature references for articles published in the past 10 years (between January 2008 and January 2018) comparing closure of pmVSD by both procedures in children. The outcomes of interest were success rate, residual shunt, need for blood transfusion, complications especially complete atrioventricular block, length of hospital stay, and cost.ResultsA total of 1750 articles were identified. However, only five studies fulfilled the inclusion criteria. As regards success rate, no significant difference was found between surgical and catheter closure. Residual shunt was significantly lower in catheter closure than surgical closure [risk ratio (RR) = 0.44; 95% confidence interval (CI), 0.23–0.83, p = 0.01). The need for blood transfusion and the length of hospital stay were significantly lower in the catheter closure compared to surgical closure (RR = 0.02; 95% CI, 0.01–0.08; p < 0.00001), (RR = −4.81; 95% CI, −7.76 to −1.86; p = 0.001), respectively. However, overall complications, complete atrioventricular block, and the cost were comparable in both procedures.ConclusionTranscatheter closure of pmVSD in children was as effective as surgical closure with a lower residual shunt and need for blood transfusion, and shorter hospital stay.

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Section: Discussionmentioning

confidence: 99%

Comparison of transcatheter versus surgical closure of perimembranous ventricular septal defect in pediatric patients: A systematic review and meta-analysis

El-Kadeem¹,

Nemr²,

Amrousy³

et al. 2019

Journal of the Saudi Heart Association

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“…Our results demonstrated that the QOL of children in the minimally invasive surgery group was higher than that of those in the traditional surgery group with respect to the scores of problems related to cardiac symptoms and their treatment, drug treatment, and perception of physical appearance (< 0.05). This may be related to traditional surgical procedures that use median sternotomy and cardiopulmonary bypass, which can cause more complications and leave a long scar after the operation, whereas minimally invasive surgery is characterized by less trauma, quick recovery time, and no large incision of a median sternotomy, cardiopulmonary bypass, and vascular-related injuries [ 30 – 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Children with CHD and their parents may have mainly considered whether the cardiac malformation was corrected and whether the symptoms of CHD were improved at the early stages after the operation. Both minimally invasive and traditional surgical treatments can achieve ideal treatment outcomes for improving children’s hemodynamics [ 32 , 33 ]. At 12–36 months after the operation, children in the minimally invasive surgery group scored higher than those in the traditional surgery group ( p < 0.05), indicating that with the correction of cardiac malformation and recovery of cardiac function, the focus of children with CHD and their parents’ perception of their QOL began to shift toward their physical appearance, and permanent scarring was an important factor affecting the QOL at this stage.…”

Section: Discussionmentioning

confidence: 99%

Effects of minimally invasive and traditional surgeries on the quality of life of children with congenital heart disease: a retrospective propensity score-matched study

et al. 2021

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Background The focus of clinical care after treating congenital heart disease (CHD) has shifted from saving patients’ lives to improving their quality of life. This study aimed to examine the influence of minimally invasive and traditional surgeries on the quality of life of children with CHD. Methods This was a retrospective cross-sectional study. A total of 459 children aged 2–18 years with CHD treated at Second Xiangya Hospital of Central South University from July 2016 to June 2017 were enrolled, among whom 219 underwent minimally invasive surgery and 240 traditional surgery. The quality of life of children with CHD after surgery was reported by the patients’ parents. We applied propensity score matching to correct for confounding factors and conducted multiple linear regression analysis to examine the related effects of minimally invasive and traditional surgeries on the quality of life of children with CHD. Results The scores of problems related to perceived physical appearance in children undergoing minimally invasive surgery was higher than those in those undergoing traditional surgery (p = 0.004). Different treatment modes were independent influencing factors for problems related to perceived physical appearance in children with CHD. There was no significant difference in average treatment effect scores of children undergoing different surgical procedures in other quality of life dimensions (problems related to cardiac symptoms and their treatment, drug treatment, anxiety regarding treatment, cognitive psychology, and communication), suggesting that different operation modes were not independent influencing factors for these related problems. Conclusion Compared with traditional surgery, minimally invasive surgery can significantly improve the physical appearance perception scores of children with CHD after surgery. Therefore, minimally invasive surgery can improve the quality of life of children with CHD.

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“…The traditional treatment for VSDs is surgical repair via cardiopulmonary bypass, which has the disadvantages of large surgical trauma, a long recovery time, and scarring [ 2 ] . Another common treatment is transcatheter device closure of the VSD, which has the advantages of no incision and a fast recovery; however, radiation exposure is required [ 3 ] . In recent years, transthoracic device closure has been widely used to treat VSDs in China.…”

Section: Introductionmentioning

confidence: 99%

Application of WeChat Platform in Midterm Clinical Follow-Up of Children Who Underwent Transthoracic Device Closure of VSD

Xie¹,

Liu²,

Lei³

et al. 2022

Braz J Cardiovasc Surg

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Introduction The purpose of this study was to investigate the feasibility and superiority of using the WeChat platform for midterm clinical follow-up of children who underwent transthoracic device closure for ventricular septal defects (VSDs). Methods Ninety children with VSDs who underwent transthoracic device closure were divided into a WeChat follow-up group (WFU group) and an outpatient follow-up group (OFU group). The patients were followed up via WeChat or at an outpatient clinic three months and one year after discharge. The incidences of adverse events, associated complications, costs and time spent, loss to follow-up rate, medication adherence, and overall satisfaction were recorded. Results There was no statistically significant difference in the incidence of adverse events or postoperative complications between the two groups. Also, the loss to follow-up rate was similar between them. Compared with the OFU group, there were significant statistical advantages in the WFU group regarding the total time and cost spent, medication adherence, and satisfaction. Conclusion The use of the WeChat platform in midterm clinical follow-up of children who underwent transthoracic device closure for VSDs has the advantages of reducing financial and time burdens, facilitating high medication adherence, and leading to high satisfaction.

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Comparison of transcatheter closure, mini-invasive closure, and open-heart surgical repair for treatment of perimembranous ventricular septal defects in children

Abstract: Supplemental Digital Content is available in the text

Cited by 15 publications

References 26 publications

Comparison of transcatheter versus surgical closure of perimembranous ventricular septal defect in pediatric patients: A systematic review and meta-analysis

Comparison of transcatheter versus surgical closure of perimembranous ventricular septal defect in pediatric patients: A systematic review and meta-analysis

Effects of minimally invasive and traditional surgeries on the quality of life of children with congenital heart disease: a retrospective propensity score-matched study

Application of WeChat Platform in Midterm Clinical Follow-Up of Children Who Underwent Transthoracic Device Closure of VSD

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