"Swiss cheese" septal defects: surgical closure using a single patch with intermediate fixings.
BACKGROUND
Residual ventricular septal defects and ventricular and septal dysfunctions are surgical drawbacks of "Swiss cheese" defects. We developed a technique that uses a single patch with intermediate fixings to cover the right side of the septum without producing a septal bulging, through a right atriotomy.


METHODS
Since April 1993, 5 children with "Swiss cheese" defects have been operated on using this procedure (mean age, 17 +/- 12 months). Three patients had associated lesions including tetralogy of Fallot, Taussig Bing heart, and mitral stenosis.


RESULTS
There have been no early or late deaths. The mean follow-up time is 29 +/- 18 months. All patients are asymptomatic. Echocardiography revealed either an intact septum (n = 4) or insignificant color jets at the apical portion of the septum (n = 1). The septal wall motion was preserved in 4 children and was hypokinetic in the fifth child.


CONCLUSIONS
This technique can be an additional tool to provide a secure closure of "Swiss cheese" defects even in the presence of associated cardiac lesions. Long-term consequences of this procedure on septal wall motion remain to be determined.
Macé
L
L
Department of Cardiovascular and Pediatric Cardiac Surgery, Marie Lannelongue Hospital, Paris-Sud University, Paris, France. mace@ccml.com
Dervanian
P
P
Le Bret
E
E
Folliguet
T A
TA
Lambert
V
V
Losay
J
J
Neveux
J Y
JY
D006348:Cardiac Surgical Procedures / Q000379:methods*; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000150:complications; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D013536:Suture Techniques; D016896:Treatment Outcome