Surgical closure of apical multiple muscular septal defects via right ventriculotomy using a single patch with intermediate fixings.
BACKGROUND
Multiple apical muscular ventricular septal defects (VSDs) remain a challenge for surgeons because of their anatomical features. We used single patch with intermediate fixations to repair multiple apical muscular VSDs through right ventriculotomy.


METHODS
We analysed the data of 16 children (median age 8 months, range 2 months to 144 months) with multiple apical muscular VSDs who underwent a single patch technique via apical right ventriculotomy. Perioperative data were collected and analysed, and the patients were followed up for three months to 66 months (median, 46 months) to investigate the outcomes.


RESULTS
All patients recovered from cardiopulmonary bypass easily with median of cardiopulmonary bypass time 87 minutes and of aortic crossclamp time 53 minutes. No surgically related death occurred and no patient required reoperation. One patient died of pseudomonas pyocyanea infection on day 11 postoperatively. Residual shunt happened in one patient with a diameter of 2 mm and spontaneously closed in 12 months after operation. Two patients presented slightly reduced right ventricular volume and apical hypokinesia postoperatively and recovered 24 and 36 months later respectively. No other complication was found during the three months to 66 months follow-up.


CONCLUSIONS
Our experiences using a single patch technique with intermediate fixations via right ventriculotomy in the management of multiple muscular VSDs had favourable outcomes.
Paediatric Heart Centre, Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Gang
G
Li
Qiang
Q
Wang
Ying-long
YL
Liu
Yu-lin
YL
Xu
Yan
Y
Guo
D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D016896:Treatment Outcome