Repair of Multiple Muscular Ventricular Septal Defects: Septal Obliteration Technique

Çetin, Gürel; Özkara, Ahmet; Akçevin, Atıf; Korkut, Ali Kubilay; Soyler, Ilksen; Köner, Özge; Tirelı, Emin

doi:10.1111/j.1540-8191.2005.200468.x

Cited by 10 publications

(52 citation statements)

References 7 publications

(9 reference statements)

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“…Treatment options include palliative pulmonary banding, primary surgical repair with right or/and left ventriculotomies, hybrid transcatheter or intraoperative device closure, sandwich technique and re-endocardialization strategy. Despite of the improvements in repairing this challenging pathology, the overall results are still barely satisfactory with significant operative mortality and complications, including ventricular dysfunction, residual shunt and complete heart block [2][3][4][5].…”

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

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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 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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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

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“…Some authors 2 consider the right atrial approach as the most difficult way to achieve the closure of multiple apical ventricular septal defects; therefore, they recommend a palliative surgery with a pulmonary artery banding to prevent congestive heart failure in early infancy and allow the heart cavities to grow. Pulmonary artery banding operation, however, has high mortality in the early postoperative period and in addition causes progressive right ventricular hypertrophy and diastolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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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.

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“…The surgical repair was an uncomplicated and successful procedure. The patient has been in good health throughout her childhood, teens, and early 15 and Cetin et al 16 adulthood. A single uncomplicated pregnancy in her early 20s was well tolerated.…”

Section: Presentations Of Cases Casementioning

confidence: 96%

“…[9][10][11][12][13] Residual shunts, multiple reoperations, impaired ventricular function, ventricular aneurysm formation and scar-related tachyarrythmia after ventriculotomy still present challenges even in those who have had acceptable surgical closure. [14][15][16][17][18] Percutaneous and hybrid closure techniques have become increasingly an alternative to open VSD repair. These techniques have been proven safe and effective even when used in small infants.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Hofmeyr

Pohlner

Radford

2013

Congenital Heart Disease

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Repair of Multiple Muscular Ventricular Septal Defects: Septal Obliteration Technique

Cited by 10 publications

References 7 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

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

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

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