Long-term Complications Following Surgical Patch Closure of Multiple Muscular Ventricular Septal Defects

Hofmeyr, Lou; Pohlner, Peter; Radford, Dorothy J.

doi:10.1111/chd.12038

Cited by 13 publications

(20 citation statements)

References 34 publications

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“…They applied this modi ed single patch technique in 5 cases with promising short term results. However, long term in adult life, the reduced size of right ventricle, and diastolic dysfunction cause problem, such as cyanosis, right heart failure, cirrhosis, arrhythmia [14]. The reason may be related to the fact that in most of the cases, the material of the patches being used to close the defects were Dacron and did not have growth potential.…”

Section: Discussionmentioning

confidence: 99%

Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

Shi

Chen

et al. 2021

Preprint

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Background “Swiss Cheese” ventricular septal defects (VSDs) is a kind of rare and complex congenital heart defects and the surgical management remains controversial and a challenge. We reviewed our preliminary clinical experience on biventricular surgical repair of “Swiss Cheese” VSDs with two-patch and right ventricle apex excluding technique in 10 cases.Methods From May 2014 to December 2019, a series of 10 patients (M/F=3/7) were admitted in our center. 9 cases underwent one-stage surgical repair with two-patch and right ventricle apex excluding technique and 1 case received two-stage surgical repair with the same technique. Surgical repair was done with cardiopulmonary bypass (CPB) in all cases. 2 fresh autologous pericardium patches were used to close defects of the outflow tract area and the apex trabecular area respectively and as a result, the right ventricular apex was excluded from the right ventricular inflow tract.Results All operations were successful. Median CPB time and aortic clamping time were 96 min and 68 min respectively. Delayed chest closure was performed in 2 cases within 48-72 hours postoperatively. The Median time of mechanical ventilation and ICU stay were 131.3 hours and 8 days respectively. Median length of hospital stay after operation was 11 （9-42）days. There was no mortality and major complication except for 2 cases of ventilator associated pneumonia. There was no death and major complication during a median follow-up time of 3.2 years.. The latest echocardiography results showed the left and right heart function was normal in all the cases.Conclusions Biventricular surgical repair of “Swiss Cheese” VSDs with two-patch of fresh autologous pericardium and right ventricle apex excluding technique in infants is safe and feasible with favorable early and mid-term results. Long term results need to be evaluated with more cases.

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Section: Discussionmentioning

confidence: 99%

Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

Shi

Chen

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…They applied this modified single patch technique in 5 cases with promising short term results. However, long term in adult life, the reduced size of right ventricle, and diastolic dysfunction cause problem, such as cyanosis, right heart failure, cirrhosis, arrhythmia [14]. The reason may be related to the fact that in most of the cases, the material of the patches being used to close the defects were Dacron and did not have growth potential.…”

Section: Discussionmentioning

confidence: 99%

Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

Shi

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background “Swiss Cheese” ventricular septal defects (VSDs) is a kind of rare and complex congenital heart defects and the surgical management remains controversial and a challenge. We reviewed our preliminary clinical experience on biventricular surgical repair of “Swiss Cheese” VSDs with two-patch and right ventricle apex excluding technique in 10 cases. Methods From May 2014 to December 2019, a series of 10 patients (M/F=3/7) were admitted in our center. 9 cases underwent one-stage surgical repair with two-patch and right ventricle apex excluding technique and 1 case received a second-stage surgical repair with the same technique. Surgical repair was done with cardiopulmonary bypass (CPB) in all cases. 2 fresh autologous pericardium patches were used to close defects of the outflow tract area and the apex trabecular area respectively and as a result, the right ventricular apex was excluded from the right ventricular inflow tract. Results All the operations were successful. Median CPB time and aortic clamping time were 96 min and 68 min respectively. Delayed chest closure were done in 2 cases within 48-72 hours postoperatively. The Median time of mechanical ventilation and ICU stay were 131.3 hours and 8 days respectively. Median length of stay after operation was 11 （9-42）days. There was no mortality and major complication except for 2 cases of ventilator associated pneumonia. There was no death and major complication during the median follow-up time of 3.2 years.. The latest echocardiography results showed the left and right heart function was normal in all the cases. Conclusions Biventricular surgical repair of “Swiss Cheese” VSDs with two-patch of fresh autologous pericardium and right ventricle apex excluding technique in infants is safe and feasible with favorable early and mid-term results. Long term results need to be evaluated with more cases.

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“…8 Large patch closures of apical VSDs that sequester a portion of the right ventricle were not performed and have been associated with poor long-term outcomes. 16 The sandwich technique has become a widely accepted option for multiple VSD management following positive initial results. 4,7,9,17 The technique avoids the need for trabecular resection and ventriculotomy, although can involve considerable patch material.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Patients Undergoing Surgical Management of Multiple Ventricular Septal Defects

Daley

Konstantinov

Brink

et al. 2019

Seminars in Thoracic and Cardiovascular Surgery

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Long-term Complications Following Surgical Patch Closure of Multiple Muscular Ventricular Septal Defects

Cited by 13 publications

References 34 publications

Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

Outcomes of Patients Undergoing Surgical Management of Multiple Ventricular Septal Defects

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