Surgical closure of multiple large apical ventricular septal defects: how we do it.
The management of apical ventricular septal defects continues to be challenging because of the difficulty in achieving a complete closure without a left apical ventriculotomy. In this study, we present our innovative technique of closing multiple and/or large muscular apical ventricular septal defects through a right atriotomy. We operated three patients with multiple apical muscular trabecular ventricular septal defects ("Swiss cheese") using a technique that involved exclusion of the right ventricular apex. Their ages ranged between 2 months and 13 years. The VSDs were approached through right atriotomy. The trans right atrial approach using a 5-0 polypropylene purse-string suture or a two-patch procedure is a novel method of closing large apical ventricular septal defects. It was found to be effective with no persistent residual defects and did not have the disadvantages of a ventriculotomy.
Pediatric Cardiac Surgery,Hospital Sant Joan de Deu,Barcelona,Spain.
Carolina
C
Perez-Negueruela
Pediatric Cardiac Surgery,Hospital Sant Joan de Deu,Barcelona,Spain.
Joan
J
Carretero
Pediatric Cardiac Surgery,Hospital Sant Joan de Deu,Barcelona,Spain.
Javier
J
Mayol
Pediatric Cardiac Surgery,Hospital Sant Joan de Deu,Barcelona,Spain.
José M
JM
Caffarena
D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome
Swiss cheese; Ventricular septal defect; congenital cardiac surgery; multiple apical ventricular septal defects