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Published on: February 8, 2022
Swiss-cheese ventricular septal defect closure by combination sandwich patch
Hajime Sakurai1, Toshimichi Nonaka1, Takahisa Sakurai1
1Department of Cardiovascular Surgery, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan.
Insights
A novel "Swiss-cheese" ventricular septal defect repair used a combination patch technique. This approach offers a potential alternative to the Fontan operation for complex septal defects.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Sieve-like "Swiss-cheese" ventricular septal defects (VSDs) present complex surgical challenges.
- Conventional management may involve palliative procedures like the Fontan operation.
- Surgical closure requires precise defect delineation and repair strategies.
Observation:
- A 7-year-old boy with a history of neonatal pulmonary artery banding had a complex "Swiss-cheese" VSD.
- The defect involved high-, mid-, and low-trabecular septal regions.
- A right ventriculotomy facilitated access and division of muscle trabeculations.
Findings:
- A combination sandwich patch technique was employed for near-complete VSD closure.
- Division of septal and moderator bands aided in defining defect margins.
- The surgical approach successfully addressed the multi-focal nature of the defect.
Implications:
- This combination patch technique provides a viable surgical option for complex "Swiss-cheese" VSDs.
- It may offer an alternative to the Fontan operation in select pediatric cases.
- Further research can explore the long-term outcomes of this innovative repair strategy.
Abstract:
A 7-year-old boy with a history of neonatal pulmonary artery banding underwent almost complete closure of a sieve-like "Swiss-cheese" ventricular septal defect, using a combination sandwich patch technique through a right ventriculotomy. Although defects existed in the high-, mid-, and low-trabecular septa, a right ventriculotomy and division of the muscle trabeculations continuing the septal and moderator bands helped delineate the edges of the defects. Although patients with "Swiss-cheese" ventricular septal defects may be candidates for a Fontan operation conventionally, a combination patch technique could be considered the procedure of choice.
