Patient inclusion
A total of 131 children who underwent PmVSD closure via a left parasternal ultra-minimal intercostal incision between January 2015 to January 2019 were included in this study. The children patients were diagnosed with restrictive PmVSD based on clinical signs, transthoracic echocardiography (TTE), electrocardiograms and X-rays.
The inclusion criteria were as follows: no obvious reduction of the size of PmVSD,slow weight gain and loud heart murmurs; no or mild tricuspid regurgitation(TR) without valvular heart disease; the distance between the PmVSD upper rim and the aortic valve larger than 2 mm. The exclusion criteria were as follows: non-restrictive VSD; malalignment-type VSD; valve abnormality that require surgical repair; severe pulmonary hypertension and other heart diseases; other surgical contraindications. Informed consent was obtained from all the guardians of the patients.