Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-01T21:02:04.188Z Has data issue: false hasContentIssue false

Surgical closure of multiple large apical ventricular septal defects: how we do it

Published online by Cambridge University Press:  06 February 2017

Carolina Perez-Negueruela*
Affiliation:
Pediatric Cardiac Surgery, Hospital Sant Joan de Deu, Barcelona, Spain
Joan Carretero
Affiliation:
Pediatric Cardiac Surgery, Hospital Sant Joan de Deu, Barcelona, Spain
Javier Mayol
Affiliation:
Pediatric Cardiac Surgery, Hospital Sant Joan de Deu, Barcelona, Spain
José M. Caffarena
Affiliation:
Pediatric Cardiac Surgery, Hospital Sant Joan de Deu, Barcelona, Spain
*
Correspondence to: C. Perez-Negueruela, Cardiac Surgery, Paseo de Sant Joan de Déu 2, 08902 Esplugues de Llobregat, Barcelona, Spain. Tel: 677 721 819; Fax: 932 532 149; E-mail: carolinanegueruela@hotmail.com

Abstract

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.

Type
Brief Report
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Holzer, R, Balzer, D, Cao, QL, Lock, K, Hijazi, ZM. Amplatzer muscular ventricular septal defect investigators. Device closure of muscular ventricular septal defects using the amplatzer muscular ventricular septal defect occluder: immediate and mid-term results of a US registry. J Am Coll Cardiol 2004; 43: 12571263.Google Scholar
2. Cetin, G, Ozkara, A, Akcevin, A, et al. Repair of multiple muscular ventricular septal defects: septal obliteration technique. J Card Surg 2005; 20: 274277.Google Scholar
3. Gu, Q, Zhou, J, Gu, H, Zhang, Y. Surgical management of apical muscular ventricular septal defects using the sandwich technique. J Card Surg 2013; 28: 301305.CrossRefGoogle ScholarPubMed
4. Shin, HJ, Jhang, WK, Park, JJ, et al. Left ventricular function after left ventriculotomy for surgical treatment of multiple muscular ventricular septal defects. Ann Thorac Surg 2011; 92: 14901493.Google Scholar
5. Ootaki, Y, Yamaguchi, M, Yoshimura, N, Oka, S, Yoshida, M, Hasegawa, T. Surgical management of trabecular ventricular septal defects: the sandwich technique. J Thorac Cardiovasc Surg 2003; 125: 508512.Google Scholar
6. Mishra, A, Shah, R, Desai, M, et al. A simple surgical technique for closure of apical muscular ventricular septal defect. J Thorac Cardiovasc Surg 2014; 148: 25762579.CrossRefGoogle ScholarPubMed