title: Surgical strategies and novel alternatives for the closure of ventricular septal defects.
abstract: A variety of therapies are available to close ventricular septal defects (VSDs). These include surgical closure on bypass, percutaneous device closure, as well as perventricular hybrid closure. Due to the incidence of heart block (1-5%) associated with percutaneous device closure of perimembranous VSDs, surgical closure presently remains the gold standard and preferred therapy for these defects. Therapeutic options are more varied for muscular VSDs. Beyond infancy, transcatheter closure offers excellent results with low morbidity and mortality, without the need for cardiopulmonary bypass. Infants however have a higher incidence of adverse events using a percutaneous approach. Large mid-muscular VSDs in infants can be treated successfully using a hybrid approach, surgical closure on bypass or a percutaneous approach. However, VSDs located apically or anteriorly are difficult to identify surgically and for these infants, perventricular hybrid closure should be considered as the preferred therapeutic modality. However, some VSD's also can be closed percutaneously.
authors.affiliation: a Division Chief Cardiology (Acting) , Sidra Medical and Research Center , Doha , Qatar.
authors.forename: Ralf J
authors.initials: RJ
authors.lastname: Holzer
authors.affiliation: b Cardiothoracic Department , Hamad Medical Corporation , Doha , Qatar.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Sallehuddin
authors.affiliation: c Department of Pediatrics , Sidra Medical and Research Center , Doha , Qatar.
authors.forename: Ziyad M
authors.initials: ZM
authors.lastname: Hijazi
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D016896:Treatment Outcome
keywords: VSD; cardiac catheterisation; device closure; hybrid therapy; surgical therapy