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A Simple Technique for Closing Multiple Muscular and Apical Ventricular Septal Defects
Sachin Talwar1, Amolkumar Bhoje1, Balram Airan1
1Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
Journal of Cardiac Surgery
|June 30, 2015
Summary
A novel biventricular surgical technique effectively closes multiple ventricular septal defects (VSDs). This simple method using a silk thread ensures no residual defects in patients with complex congenital heart disease.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Multiple ventricular septal defects (VSDs) present significant surgical challenges.
- Existing techniques for closing multiple muscular and apical VSDs can be complex.
Purpose of the Study:
- To describe a simple and safe surgical technique for closing multiple muscular and apical VSDs.
- To evaluate the efficacy of this novel biventricular approach.
Main Methods:
- A biventricular approach using a silk thread through the VSD was employed in 52 patients between 2010 and 2013.
- The technique involved passing a thread through the VSD into the left ventricle, out through the mitral valve and interatrial septum, followed by suturing.
Main Results:
- The study included 52 patients (34 male, age 45 days to 5.5 years) with various VSD configurations, including "Swiss Cheese septum."
- Intraoperative transesophageal echocardiograms showed no significant residual shunts.
- One hospital death occurred due to sepsis; follow-up in 48 patients revealed no residual VSDs.
Conclusions:
- The biventricular, trans-right atrial, trans-interatrial septum thread-through-hole method is effective for closing multiple muscular VSDs.
- This technique demonstrates a high success rate with no persistent residual defects.
