KẾT QUẢ NGẮN HẠN PHẪU THUẬT ÍT XÂM LẤN QUA ĐƯỜNG DỌC GIỮA NÁCH BÊN PHẢI ĐIỀU TRỊ BỆNH THÔNG LIÊN THẤT DƯỚI HAI VAN ĐỘNG MẠCH TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objective: To evaluate the feasibility, the safety and short-term outcomes of surgical repair for doubly committed ventricular septal defect through the right vertical axillary mini-thoracotomy at Vietnam National Children’s Hospital. Methods: Retrospective study was performed for patients who underwent surgical repair of doubly committed ventricular septal defect through the right vertical axillary mini-thoracotomy at Heart Center-Vietnam National Children’s Hospital from January 2020 to December 20121. Results: There were a total of 24 patients included in this study, which included 13 males and 11 females. The median weight of patients was 8.1 kg (IQR, 5.9 – 21.2 kg), the median age was 10 months (6 – 91.6 months). The mean diameter of the ventricular septal defect was 8.5 ± 2.8 mm. Five patients (20.8%) associated with patent ductus arteriosus and 1 patient (4.2%) have atrial septal defect. Surgical approach was performed through the right atrium in 3 patients (12.5%) and through the main pulmonary trunk in 21 patients (87.5%). The mean aortic cross clamp time was 56.7 ± 20.9 minutes, the mean bypass time was 73.8 ± 23.5 minutes, the mean preparation for bypass time was 37.6 ± 8.3 minutes, and the mean operation time was 161.5 ± 33.4 minutes. There were no mortality and no conversion to the other operation approach. The mean ventilation time was 10.6 ± 6.2 hours, and the mean postoperative length of stay was 8.5 ± 3.3 days. Three patients (12.5%) suffered arrythmia which included: 1 patient have junctional ectopic tachycardia, 1 patient have sinus bradycardia, and 1 patient have atrial tachycardia. No residual ventricular septal defect was detected after operation. Follow-up was completed for all patient in our study with mean time follow-up was 17 ± 6.8 months, which is show no chest deformity in all patient. All patient and their family were satisfactory with the cosmetic results of the approach. Conclusions: Surgical repair for doubly committed ventricular septal defect through the right vertical axillary mini-thoracotomy was feasible and safe, with an excellent short-term outcome. Further investigation with a bigger patient number and longer follow-up time are essential.