Related Experiment Video
Updated: May 30, 2026
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Left ventricular function after left ventriculotomy for surgical treatment of multiple muscular ventricular septal
Hong Ju Shin1, Won Kyoung Jhang, Jeong-Jun Park
1Department of Cardiovascular Surgery, Konkuk University Medical Center, Seoul, Republic of Korea.
Insights
Surgical closure of muscular ventricular septal defects (MVSD) using left ventriculotomy shows acceptable long-term left ventricular function. This technique offers a viable option for managing MVSD in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Echocardiography
Background:
- Management of muscular ventricular septal defects (MVSD) remains debated.
- Long-term left ventricular (LV) function post-MVSD closure is not well-established.
Purpose of the Study:
- To evaluate surgical outcomes and long-term LV function after MVSD closure via left ventriculotomy.
- To assess the viability of left ventriculotomy for MVSD management.
Main Methods:
- Retrospective review of 20 pediatric patients undergoing MVSD closure (1993-2010).
- Analysis of patient demographics, surgical procedures (patch vs. direct closure), and follow-up data.
- Assessment of LV function using echocardiography at long-term follow-up.
Main Results:
- One hospital death (5%) and one late death occurred.
- Median follow-up was 85.9 months.
- Echocardiography revealed normal LV ejection fraction (65.2% ± 8.2%) post-closure with no significant residual shunts.
Conclusions:
- Left ventriculotomy for MVSD closure demonstrates acceptable long-term LV function.
- This surgical approach is a potentially viable option for managing MVSD.
Background:
Optimal management of muscular ventricular septal defects (MVSD) is still not determined in the current era. Moreover, long-term left ventricular function after closure of MVSD is not well known. Thus, we investigated surgical outcomes including long-term left ventricular function after closure of MVSD through left ventriculotomy.
Methods:
We conducted a retrospective review of medical records of 20 children who underwent MVSD closure between March 1993 and August 2010. There were 10 boys (50%) and 10 girls (50%). Patient age ranged from 1.6 to 103.4 months (median, 26.4 months), and body weight from 2.8 to 31.5 kg (median, 11.9 kg). Electrocardiogram results were normal sinus rhythm in all except 1 patient with congenital complete atrioventricular block. There were 16 patients who previously had palliative pulmonary artery banding procedures before closure of MVSD. There were 13 patients (65%) with Swiss-cheese type VSD.
Results:
There was 1 hospital death of a patient with congenital complete atrioventricular block with pacemaker malfunction (5%). There was 1 late death of a patient with del 22q with adenoviral pneumonia. There was no reoperation. Median follow-up duration was 85.9 months (range, 4.7 to 166.7). The location of MVSD was apical portion in 10 patients (50%) and midtrabecular portion in 9 patients (45%). There were 6 Dacron patch closures and 13 direct closures of MVSD through left ventriculotomy. There was no complete atrioventricular block. Last follow-up echocardiographic data showed normal ejection fraction with 65.2% ± 8.2% after closure of MVSDs. There was no leakage in 8 patients; 11 patients had insignificant leakage, which disappeared spontaneously in 4 patients 17.9 months (median value) after operation.
Conclusions:
Our acceptable long-term results of left ventricular function after left ventriculotomy proved that this technique might be a viable option in the management of MVSD.
More Related Videos
08:19Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
Published on: July 12, 2022
09:40Induction of Right Ventricular Failure by Pulmonary Artery Constriction and Evaluation of Right Ventricular Function in Mice
Published on: May 13, 2019
