Surgical closure of apical multiple muscular septal defects via right ventriculotomy using a single patch with intermediate fixings

• Published in: Chinese medical journal 2013, Vol.126 (15), p.2866-2870
• Main Authors: Li, Gang, Wang, Qiang, Liu, Ying-long, Xu, Yu-lin, Guo, Yan
• Format: Article
• Language: English
• Subjects: Cardiac Surgical Procedures - methods; Cardiopulmonary Bypass; Child; Child, Preschool; Female; Follow-Up Studies; Heart Septal Defects, Ventricular - surgery; Heart Ventricles; Humans; Infant; Male; Postoperative Complications; Treatment Outcome; 体外循环; 外科手术; 室间隔缺损; 平均年龄; 循环时间; 肌肉; 补丁; 驱动技术
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.20121043

Background Multiple apical muscular ventricular septal defects （VSDs） remain a challenge for surgeons because of their anatomical features. We used single patch with intermediate fixations to repair multiple apical muscular VSDs through right ventricuiotomy. Methods We analysed the data of 16 children （median age 8 months, range 2 months to 144 months） with multiple apical muscular VSDs who underwent a single patch technique via apical right ventdcu~otomy. Perioperative data were collected and analysed, and the patients were followed up for three months to 66 months （median, 46 months） to investigate the outcomes. Results All patients recovered from cardiopulmonary bypass easily with median of cardiopulmonary bypass time 87 minutes and of aortic crossclamp time 53 minutes. No surgically related death occurred and no patient required reoperation. One patient died of pseudomonas pyocyanea infection on day 11 postoperatively. Residual shunt happened in one patient with a diameter of 2 mm and spontaneously closed in 12 months after operation. Two patients presented slightly reduced right ventricular volume and apical hypokinesia postoperatively and recovered 24 and 36 months later respectively. No other complication was found during the three months to 66 months follow-up. Conclusion Our experiences using a single patch technique with intermediate fixations via right ventriculotomy in the management of multiple muscular VSDs had favourable outcomes.