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Date Published: 26/08/2022
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Views PDF: 117
DOI: https://doi.org/10.51298/vmj.v517i2.3271
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Vol. 517 No. 2 (2022)
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Các bài báo
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Trung Nam, N. ., & Lý Thịnh Trường, N. . (2022). OPEN HEART SURGERY USING THE VERTICAL RIGHT AXILLARY MINI-THORACOTOMY FOR TREATMENT OF LARGE VENTRICULAR SEPTAL DEFECT AT HANOI NATIONAL CHILDREN’S HOSPITAL. Vietnam Medical Journal, 517(2). https://doi.org/10.51298/vmj.v517i2.3271

OPEN HEART SURGERY USING THE VERTICAL RIGHT AXILLARY MINI-THORACOTOMY FOR TREATMENT OF LARGE VENTRICULAR SEPTAL DEFECT AT HANOI NATIONAL CHILDREN’S HOSPITAL

Nguyễn Trung Nam1, Nguyễn Lý Thịnh Trường2,
1 Thanh Hoa Pediatric Hospital
2 Children Heart Center, Vietnam National Children's Hospital

Main Article Content

Abstract

Objective: Evaluation of short-term outcomes for surgical treatment of large ventricular septal defect (VSD) using the vertical right axillary mini-thoracotomy at Hanoi National Children's Hospital. Methods: From January 2020 to December 2021, a total of 93 patients, diagnosed with a large VSD (diameter >6.5mm) undergoing VSD closure using the vertical right axillary mini-thoracotomy, were retrospective at Hanoi National Children’s Hospital.  Results: The median age at operation was 11.2 months (IQR, 6.4-25.4), and the median weight was 7.7kg (IQR, 6.4-11.5). There were 49 males and 44 females. The mean diameter of the VSD was 9,1 ± 1.8mm, mean pulmonary artery pressure was 38,2±13,4 mmHg (min:20-max:85). The mean length of incision was 5,6±0,5cm (min:5-max:7). The aortic cross-clamped time was 51,6±12,4minutes, bypass time was 68,9±15minutes and preparation time for bypass was 37,1 ±8,6minutes. There were 73 patients who have peri-membranous VSD, 19 patients have doubly committed VSD or muscular outlet VSD, and 1 patient who have an inlet VSD. The VSD closure was approached through the right atrium in 75 patients (80.6%) and through the pulmonary artery in 18 patients (19.4%). There was no early mortality, no late mortality, no reoperation, and no patient who required a permanent pacemaker due to complete atrioventricular block. There were 3 patients have wound infections, 3 patients have right upper lung atelectasis and 26 patients have a minor pneumothorax. The mean postoperative length of stay was 8 days (min:5-max:35). The echocardiography postoperative showed 8 patients who have a small residual VSD. However, after a mean follow-up of 13 ± 5,9months (min:6-max:30), there was no patient who revealed a residual VSD. All patients are stable with normal exercise activity and 97% of patients have normal development of the chest. Conclusions: The results of the vertical right axillary mini-thoracotomy for treatment of a large VSD at Hanoi National Children’s Hospital were safe, effective, and high-value of cosmetics. Alarger number of patients with a longer follow-up time are essential for evaluation of this surgical approach.

Article Details

Keywords

mini-invasive for open heart surgery, large ventricular septal defect, the vertical right axillary mini-thoracotomy

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