title: Transaortic approach for a closure of a residual ventricular septal defect of the tetralogy of Fallot.
abstract: BACKGROUND
  A residual ventricular septal defect as part of the tetralogy of Fallot (TOF) is often difficult to close when a long interval has elapsed after a radical operation or the position of the defect is problematic.
  
  
  METHODS
  When an accurate diagnosis and closure of a residual ventricular septal defect (VSD) were not obtainable through right atriotomy and right ventriculotomy, the ascending aorta was opened. The smooth surface of the left ventricular septum makes it possible to find the position of the defect, and close it accurately and safely.
  
  
  RESULTS
  Three consecutive patients were operated upon using this method. They had undergone repair of tetralogy of Fallot anomalies 8 years, 26 years, and 21 years prior to this surgery, respectively. All patients survived the operation and were discharged from the hospital. None of the patients had residual defects, aortic regurgitation, or new atrioventricular block.
  
  
  CONCLUSIONS
  This transaortic approach for closing residual ventricular septal defects related to the tetralogy of Fallot offers an alternate method when either the right atrial or right ventricular approach cannot be performed successfully. This approach may make it possible to close such defects directly.
authors.affiliation: Department of Thoracic Surgery, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-0065, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Sakai
authors.forename: M H
authors.initials: MH
authors.lastname: Song
authors.forename: T
authors.initials: T
authors.lastname: Shimomura
authors.forename: K
authors.initials: K
authors.lastname: Tajima
authors.forename: K
authors.initials: K
authors.lastname: Yasuura
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013771:Tetralogy of Fallot / Q000601:surgery*; D013997:Time Factors