Efficacy of Trans-thoracic Minimally Invasive Closure in High-Risk Children with Ventricular Septal Defect
Objective To investigate the therapeutic effect of trans-thoracic minimally invasive closure on high-risk children with ventricular septal defect(VSD).Methods Eighty high-risk children with VSD who were admitted to Zhengzhou People's Hospital from February 2015 to January 2022 were selected as the study subjects.Based on different surgical methods,the subjects were divided into group A(36 children treated with traditional VSD repair under extracorporeal circulation)and group B(44 children treated with TEE-guided trans-thoracic minimally invasive closure).All children were followed up for 1 year.The total effective rate,operation-related indicators,cardiac function indicators,inflammatory factor levels and the incidence of postoperative adverse events were recorded and analyzed.Results The total clinical response rate in group B(90.91％)was higher than that in group A(72.22％)(P＜0.05).Operation-related indicators in group B were better than those in group A(P＜0.05).One year after operation,left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)decreased,and left ventricular ejection fraction(LVEF)increased in the two groups(P＜0.05).There was no significant difference in cardiac function indicators between the two groups(P＞0.05).On the 3rd day after operation,C-reactive protein(CRP)levels and white blood cell count in the two groups decreased(P＜0.05).The levels of inflammatory factors in group B were lower than those in group A(P＜0.05).The total incidence rate of adverse events in group B(6.81％)was lower than that in group A(22.22％)(P＜0.05).Conclusion TEE-guided trans-thoracic minimally invasive closure is effective in the treatment of high-risk children with VSD.It can alleviate postoperative inflammatory reactions,promote cardiac function recovery,and reduce the incidence of adverse events.
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