1 安徽省儿童医院心血管外科，合肥 230022
Efficacy and safety of modified ventricular septal defect repair in children with perimembranous ventricular septal defect
CorrespondingAuthor: WU Pengpeng Email: firstname.lastname@example.org
Objective: To compare the efficacy and safety of modified ventricular septal defect (VSD) repair and traditional surgery for treatment of perimembranous VSD. Methods: A total of 100 children with perimembranous VSD admitted to Anhui Children’s Hospital from September 2019 to February 2021 were randomly divided into a modified group and a control group, with 50 cases in each group. The modified group received modified VSD repair treatment, and the control group received traditional surgical treatment. The patients were followed up at 3, 6 and 12 months after the operation. The general condition, serum C-reactive protein (CRP), white blood cell count (WBC), cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), left ventricular function, pulmonary artery, and aortic valve blood flow velocity before and after the operation, and the incidence of complications were compared between the 2 groups. Results: There was no significant difference in gender, age, body weight, VSD defect diameter, American Society of Anesthesiologists (ASA) classification, and New York Heart Association (NYHA) cardiac function classification between the 2 groups (all P>0.05). The aortic clamping time, cardiopulmonary bypass time, intraoperative blood transfusion, operation time, and postoperative hospital stay were significantly less than those in the control group (all P<0.05). After 24 h, the serum CRP, WBC, cTnI, and CK-MB levels in the modified group were significantly lower than those in the control group (all P<0.05). At 3, 6, and 12 months after the operation, LVEF and aortic valve flow velocity in the modified group were significantly higher than those in the control group (both P<0.05), while LVEDD, LVSV, and pulmonary valve flow velocity in the modified group were significantly lower than those in the control group (all P<0.05). The incidences of postoperative residual shunt, cardiac valve insufficiency, arrhythmia, and atrioventricular block in the modified group were significantly lower than those in the control group (all P<0.05). Conclusion: Modified VSD repair has better efficacy and safety in the treatment of perimembranous VSD in children, which can reduce the inflammatory response and myocardial injury, improve the prognosis of children.