Left ventricular approach to multiple ventricular septal defects.
Multiple muscular ventricular septal defects were closed through an apical left ventriculotomy in 11 patients. The patients were divided into two groups: Group 1, 8 patients who had transposition of the great arteries, and group 2, 3 patients without transposition. There were 4 deaths in Group 1 and non in Group 2. Two of the deaths were caused by a hypoplastic right ventricle, 1 by airway obstruction, and 1 by heart failure and pulmonary edema in a patient who had additional unrecognized muscular defects. An apical left ventriculotomy provides excellent exposure of the septum. The field is not obscured by trabecular bands or papillary muscles. Although 1 patient died because of residual VSDs, this approach, compared with previously described methods, minimizes the risk of unrecognized defects.
D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles; D006801:Humans; D007223:Infant; D008297:Male; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery; D011666:Pulmonary Valve Stenosis / Q000150:complications / Q000601:surgery; D013552:Swine; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery