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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 ,
Joan Carretero ,
Javier Mayol  and
José M. Caffarena
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: [email protected]
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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.

Keywords

Ventricular septal defectSwiss cheesecongenital cardiac surgerymultiple apical ventricular septal defects
Type
Brief Report
Information
Cardiology in the Young , Volume 27 , Issue 3 , March 2017 , pp. 588 - 591
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Copyright
© Cambridge University Press 2017 

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