Follow-Up Study of Electrocardiographic Indices in 252 Children with Ventricular Septal Defect after Minimally Invasive Transthoracic Closure

Abstract

Objective: The aim of this study was to explore the efficacy and safety of minimally invasive transthoracic closure (MITC) in treating ventricular septal defect (VSD). Methods: A total of 252 children with VSD were investigated between August 2013 and March 2015. Their electrocardiographic indices were monitored at different time points (before surgery [T0], immediately after surgery [T1], and 3 days/7 days/1 month/3 months/6 months after surgery [T2–6]) and followed up every year. Related adverse events also were recorded. Results: All children with VSD successfully underwent MITC. The average follow-up time was 5 years, during which no changes in the heart rate or corrected QT interval were found. The PR and QRS intervals were prolonged in the early postoperative period (T3); the SV1+RV5 amplitude decreased significantly at T6, and the left axis deviation significantly recovered at T6 (P < 0.05). A total of 32 patients developed arrhythmia within 3 days after surgery; however, no severe arrhythmia, including ventricular tachycardia, ventricular fibrillation, second-and third-degree atrioventricular block, complete left or right bundle branch block, and delayed arrhythmia, occurred during the follow-up period. Binary multivariate logistic regression revealed that the longer the surgery time and the larger the VSD diameter, the higher the risk of arrhythmia. Conclusions: The incidence of long-term arrhythmia after MITC is low, and the outcomes are good.