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Surgical management of apical muscular ventricular septal defects using the sandwich technique

Qun Gu1, Jie Zhou, Haitao Gu

  • 1Department of Pediatric Cardiothoracic Surgery, Jiangsu Province Hospital, Nanjing, China.

Journal of Cardiac Surgery
|May 17, 2013
PubMed

Insights

The sandwich technique safely closes apical muscular ventricular septal defects (VSDs). This method shows promising results with minimal residual shunts that often resolve over time.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Defects

Background:

  • Apical muscular ventricular septal defects (VSDs) present unique surgical challenges.
  • Effective closure techniques are crucial for improving outcomes in pediatric patients with complex congenital heart disease.

Purpose of the Study:

  • To evaluate the safety and efficacy of the sandwich technique for closing apical muscular VSDs.
  • To assess the role of this technique in managing patients with associated cardiac malformations.

Main Methods:

  • The sandwich technique was employed for VSD closure in 21 pediatric patients.
  • Surgical access was achieved via the tricuspid valve, left ventricular side, or mitral valve.
  • All patients had associated cardiac malformations, with VSD closure performed using the described technique.

Main Results:

  • No hospital deaths occurred, and all patients experienced an uneventful postoperative course.
  • The majority of patients had no or minimal residual shunts post-surgery.
  • Interventricular septum wall motion and cardiac function remained normal one month after surgery, with all patients off cardiac medications.

Conclusions:

  • The sandwich technique is a safe and reliable method for apical muscular VSD closure.
  • Residual shunts, when present, demonstrated a tendency to decrease over time.
  • Further research and extended follow-up are needed to determine applicability in neonates and young infants.
Abstract

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