Mid-Term Outcome of the Hybrid Method of Ventricular Septal Defect Closure in Children.

Akkerbez Adilbekova 1 2 * , Bakhytzhan Nurkeev 1, Shukhrat Marassulov 1, Saken Kozhakhmetov 2
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1 Pediatric Cardiac Surgery Department, National Scientific Medical Center, Astana City, Republic of Kazakhstan
2 Department of Surgical Diseases with courses in cardiothoracic surgery and maxillofacial surgery, Аstana Medical University, Astana City, Republic of Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 21, Issue 2, pp. 66-72. https://doi.org/10.23950/jcmk/14401
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Author Contributions: Conceptualization, A.A and N.B.; methodology, A.A., N.B., M.Sh. and K.S.; validation, A.A and N.B.; formal analysis, A.A., N.B., M.Sh.; investigation, A.A and N.B.; resources, A.A and N.B.; data curation, M.Sh. and K.S.; writing – original draft preparation, A.A and N.B.; writing – review and editing, N.B., M.Sh. and K.S.; visualization, A.A., N.B., M.Sh. and K.S.; supervision, M.Sh. and K.S.; project administration, M.Sh. and K.S.; funding acquisition, M.Sh. and K.S. All authors have read and agreed to the published version of the manuscript.

Ethical Statement: This research protocol was approved by the Ethics Committee of National Scientific Medical Center, Astana, Kazakhstan (Protocol number: 081/CR-75; Assigned number: 053/СТ-63) and carried out by the principles set out in the Declaration of Helsinki 1964.

ABSTRACT

Objective: To describe the clinical experiences and mid-term follow-up results of the hybrid method of ventricular septal defect closure in children.
Methods: This study was a combined - multidirectional cohort. Between May 2016 and December 2020, 250 patients with isolated VSD (or residual VSD after a previous repair) underwent surgery by the hybrid method at the pediatric cardiac surgery department in the National Scientific Medical Center. This study adopted a combined and multidirectional cohort approach, initially starting as a retrospective cohort and later transitioning into a prospective cohort.
Results: A total of 250 patients in this cohort underwent hybrid VSD closure, of which 233 (93.2%) patients were successful, 16 (6.4%) patients were converted to the traditional method and 1 (0.4%) death occurred. New trivial or mild tricuspid regurgitation was detected in 35 patients (15%) and aortic regurgitation in 9 patients (3.9%) by intraoperative TEE. For the remaining 10 patients with incomplete right bundle branch blocks the sinus rhythm was restored in follow-up. In addition, the left ventricular ejection fraction improved over time. One of the important points after surgery is the deformation of the chest. In 122 (91%) patients, there is no deformation; unfortunately, in 12 (9%) patients, there is deformation. 
Conclusions: The hybrid method is a rapidly developing technique that has been safe and effective in a selected group of patients in recent years. The advantages of this method are minimum incision namely the size and length of the postoperative scar from 2 to 4 cm. Also, no myocardial injury, and reduces operation time, intensive care unit stay, and hospital stays.
Keywords: congenital heart disease, ventricular septal defect, hybrid method, Kazakhstan

CITATION

Adilbekova A, Nurkeev B, Marassulov S, Kozhakhmetov S. Mid-Term Outcome of the Hybrid Method of Ventricular Septal Defect Closure in Children.. J CLIN MED KAZ. 2024;21(2):66-72. https://doi.org/10.23950/jcmk/14401

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