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Double patch closure of ventricular septal defect with increased pulmonary vascular resistance

W M Novick1, A T Gurbuz, D C Watson

  • 1Le Bonheur Children's Medical Center, University of Tennessee, Memphis, USA. ichfno@aol.com

The Annals of Thoracic Surgery
|January 6, 1999
PubMed

Insights

A novel flap valve double VSD patch effectively reduces complications in children undergoing large ventricular septal defect (VSD) repair. This technique lowers postoperative morbidity and mortality in pediatric patients with elevated pulmonary vascular resistance.

Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease
  • Cardiovascular Surgery

Background:

  • Large ventricular septal defects (VSD) in children with elevated pulmonary vascular resistance carry high risks of morbidity and mortality.
  • Pulmonary hypertensive episodes are a significant postoperative concern.
  • A new surgical approach was developed to mitigate these risks.

Purpose of the Study:

  • To evaluate the safety and efficacy of a fenestrated flap valve double VSD patch.
  • To reduce morbidity and mortality in pediatric VSD closure with elevated pulmonary vascular resistance.

Main Methods:

  • Eighteen children with large VSDs and elevated pulmonary vascular resistance underwent repair using a fenestrated flap valve double VSD patch.
  • The procedure involved moderately hypothermic cardiopulmonary bypass and cardioplegic arrest.
  • A unique double patch technique with a fenestrated primary patch was employed.

Main Results:

  • All patients survived the surgery and were weaned from support within 48 hours.
  • Postoperative pulmonary artery pressures were significantly reduced compared to preoperative levels.
  • One late mortality occurred 9 months postoperatively.

Conclusions:

  • The flap valve double VSD patch is a safe and effective method for closing large VSDs in children with elevated pulmonary vascular resistance.
  • This technique significantly lowers postoperative morbidity and mortality.
Abstract

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