Intraoperative customized double-patch device with twin sutures for multiple muscular septal defects

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Medical Devices

Background:

• Multiple muscular ventricular septal defects (VSDs) present significant anatomical challenges for surgical closure.
• Existing techniques may not adequately address the complexity of multiple muscular VSDs.

Purpose of the Study:

• To evaluate the efficacy and safety of the 'Intraoperative Customized Double-Patch Device' technique for closing multiple muscular VSDs.
• To assess the feasibility of pre-operative mapping using en face echocardiographic reconstruction.

Main Methods:

• Surgical closure of multiple muscular VSDs in 39 patients using the 'Intraoperative Customized Double-Patch Device' technique.
• Pre-operative mapping of VSDs via en face reconstruction of the right ventricular septal surface using echocardiography.
• Placement of polytetrafluoroethylene patches on both ventricular sides, secured with polypropylene sutures.

Main Results:

• No in-hospital mortality observed in 39 patients undergoing the procedure.
• Mean hospital stay was 11 days; all patients remained in New York Heart Association Class I post-operatively.
• Satisfactory immediate and short-term results with no or trivial residual shunts in most patients.

Conclusions:

• The 'Intraoperative Customized Double-Patch Device' technique, combined with en face mapping, is effective for surgically closing multiple muscular VSDs.
• This approach offers satisfactory immediate and short-term outcomes in patients with complex VSDs.
• The technique is adaptable to various anatomical configurations of muscular VSDs.