Ventricular defect interventional surgery

Ventricular septal defect refers to ventricular septal dysplasia in the embryo, forming abnormal traffic, producing a left-to-right shunt at the ventricular level, which may exist alone or as part of a complex cardiac malformation. Ventricular deficiencies are the most common congenital heart disease. The ventricular septal defect is about 20% of the total number of congenital heart disease, which can exist alone or coexist with other malformations. The defect is between 0.1-3cm, which is larger in the membranous part and smaller in the muscle part, which is also called Roger's disease. If the defect is <0.5cm, the flow rate is small and there are no clinical symptoms. The small defect was mainly due to the enlargement of the right ventricle, and the left ventricle of the larger defect was more obvious than the right ventricle. Interventional treatment of ventricular septal defect uses imaging techniques to expand the doctor's field of vision and extend the doctor's hands with the aid of a catheter. The advantages of interventional therapy for ventricular septal defect compared with traditional surgery are: small trauma, no thoracotomy, only the size of a rice-like wound; only local anesthesia, short operation time, less pain for patients; high surgical safety, rapid recovery after surgery. Treatment of diseases: ventricular septal defect Indication 1. Perimembranous ventricular septal defect, usually >3 years old, simple ventricular deficiency with hemodynamic effects on the heart. The upper margin of the ventricular septum is 3 mm from the right aortic valve, and there is no aortic right coronary detachment and aortic regurgitation; 2. Muscle ventricular deficiencies. Usually the defect diameter is 5mm; 3. residual shunt after surgery; 4. Others: Myocardial infarction or post-traumatic ventricular dysfunction, although non-congenital, but its defect can still be closed by the confinement of congenital heart disease VSD. Contraindications 1. Ventricular septal defect combined with severe PH with right to left shunt. 2. Ventricular septal defect combined with other patients who need surgery for cardiac malformation. 3. Defective anatomical position is poor, and the occluder is placed to affect the function of the aortic valve or atrioventricular valve. Preoperative preparation Complete the following checks before surgery: Cardiac color ultrasound, electrocardiogram, chest X-ray, blood routine, coagulation function, liver and kidney function, electrolytes, blood infectious disease value indicators. Surgical procedure Selection of occluder: Different types of occluder should be selected according to the shape of the VSD, the size of the defect, and the distance between the defect and the aorta. Conventional puncture of the femoral artery, vein, establishment of the femoral vein - right atrium - right ventricle - VSD - left ventricle - aorta - femoral artery orbital, the femoral vein segment into the appropriate sheath and occluder for ventricular septal defect sealing After the occluder is placed in place, left ventricular angiography and echocardiography confirm whether the position of the occluder is properly integrated, and if necessary, aortic angiography is performed to observe the presence or absence of aortic regurgitation. complication 1 arrhythmia; 2. The plug is detached and embolized; 3. Valve regurgitation; 4. Thrombosis; 5. Puncture vascular complications.