目的总结通过微创手术经心室行膜部室间隔缺损(VSD)伞片封堵的临床经验,探讨该技术的手术方法和适应证。方法对48例膜部VSD患儿采用胸下小切口经心室途径封堵治疗。患儿均为膜周限制性VSD,VSD基底部直径2～9 mm;伞腰直径4～10 mm;45例采用同心伞,3例采用偏心伞。在经食管超声心动图的引导下经右心室放入室间隔封堵伞。结果 45例患儿术后心功能稳定,随访1～6个月,伞片位置无移位,无心律失常和残余分流。其余3例患儿发生心律失常,其中1例发生室性早搏和短阵性室性心动过速,2例发生房室传导阻滞,经治疗均好转。结论经胸小切口行伞片封堵膜部VSD为VSD的治疗提供了一种良好的选择,应严格把握手术适应证。 Objective To summarize the clinical experience of percutaneous ventricular septal defect (VSD) occlusion by minimally invasive surgery and to discuss the surgical methods and indications for this technique. Methods 48 cases of membranous VSD children underwent a small incision of the chest by ventricular occlusion. Children were restricted peritoneal VSD, VSD basal diameter 2 ~ 9 mm; umbrella waist diameter 4 ~ 10 mm; 45 cases of concentric umbrella, 3 cases of eccentric umbrella. Guided by transesophageal echocardiography through the right ventricle into the ventricular septal blocking umbrella. Results 45 cases of children with stable cardiac function after a follow-up of 1 to 6 months, parachute position no shift, no arrhythmia and residual shunt. The remaining three cases of arrhythmia occurred, including 1 case of premature ventricular contractions and paroxysmal ventricular tachycardia, 2 cases of atrioventricular block, after treatment were improved. Conclusion The transcatheter closure of VSD with VSD provides a good choice for the treatment of VSD. The operation indication should be strictly controlled.