title: "Swiss cheese" septal defects: surgical closure using a single patch with intermediate fixings.
abstract: 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.
authors.affiliation: Department of Cardiovascular and Pediatric Cardiac Surgery, Marie Lannelongue Hospital, Paris-Sud University, Paris, France. mace@ccml.com
authors.forename: L
authors.initials: L
authors.lastname: Macé
authors.forename: P
authors.initials: P
authors.lastname: Dervanian
authors.forename: E
authors.initials: E
authors.lastname: Le Bret
authors.forename: T A
authors.initials: TA
authors.lastname: Folliguet
authors.forename: V
authors.initials: V
authors.lastname: Lambert
authors.forename: J
authors.initials: J
authors.lastname: Losay
authors.forename: J Y
authors.initials: JY
authors.lastname: Neveux
mesh_terms: 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