Abstract
Background Transthoracic device closure (TTDC) and surgical repair with right infra-axillary
thoracotomy (SRRIAT) or with right submammary thoracotomy (SRSMT) are all the primary
alternative treatments for restrictive perimembranous ventricular septal defect (pmVSD).
However, few studies have compared them in terms of effectiveness and complications.
Methods Patients with restrictive pmVSD undergoing TTDC, or SRRIAT, or SRSMT from March 2016
to February 2017 were retrospectively reviewed in our cardiac center. There were no
differences in age (1.3 ± 1.2 vs 1.1 ± 1.1 vs 1.2 ± 1.1 years), gender (35/37 vs 30/33
vs 29/29), body weight (8.3 ± 2.6 vs 8.2 ± 2.4 vs 8.1 ± 2.5 kg), and size of VSD (4.2 ± 1.1
vs 5.2 ± 1.3 vs 5.1 ± 1.2 mm) distribution between the three groups.
Results The procedure success rates were similar in the three groups. The TTDC group had
the shortest operative time, postoperative mechanical ventilation time, duration of
intensive care, postoperative length of hospital stay, medical cost, and length of
the incision. There were no significant differences in terms of operative time, aortic
cross-clamping time, duration of cardiopulmonary bypass (CPB), blood transfusion volume,
mechanical ventilation time, duration of intensive care, duration of hospital stays,
pleural fluid drainage, or cost between the SRSMT and SRRIAT groups. No significant
differences were noted in terms of major adverse events.
Conclusions TTDC, SRRIAT, and SRSMT all showed excellent outcomes and cosmetic appearances for
selected VSD patients. TTDC had advantages over SRRIAT and SRSMT in terms of short
operation duration and smaller incision size and shorter durations of intensive care
and hospital stays.
Keywords
ventricular septal defect - transthoracic device closure - right infra-axillary thoracotomy
- submammary thoracotomy
