Original article: cardiovascularApical right ventriculotomy for closure of apical ventricular septal defects
Section snippets
Patients
A retrospective study was performed for a consecutive series of nine patients (median age, 8 months; range, 74 days–2.5 years and median weight 6.5 kg; range, 3 to 9.8 kg) who underwent an apical right ventriculotomy for apical VSD closure from November 1994 through April 2002. The study was approved by the Institutional Review Board of The Cleveland Clinic Foundation. All but one of the patients had associated congenital cardiac lesions; five patients had severe associated cardiac anomalies (
Results
The median duration of cardiopulmonary bypass was 103 minutes (range, 40 to 167 minutes) and the median cross clamp time was 61 minutes (range, 27 to 92 minutes). Additional procedures were performed in nine of the ten surgical cases (Table 2). Postoperatively, the median duration of intubation was 2 days (range, 1 to 17 days), the median time in the intensive care unit was 2 days (range, 2 to 17 days), and the median duration of hospitalization was 7 days (range, 4 to 56 days). One of the
Comment
The approach to patients with apical VSDs remains a substantial challenge due to difficult surgical access and the frequent occurrence of additional cardiac lesions. Treatment strategies must provide adequate exposure and then must allow definitive surgical closure in that residual VSDs are poorly tolerated, especially when associated with other significant lesions. In addition to these considerations, strategies for repair must preserve cardiac rhythm and should not unduly prolong ischemic
References (17)
- et al.
Outcomes of intraoperative device closure of muscular ventricular septal defects
Ann Thorac Surg
(2001) - et al.
Apical ventricular septal defectsfollow-up concerning anatomic and surgical considerations
Ann Thorac Surg
(2002) - et al.
Surgical closure of apical ventricular septal defects through a right ventricular apical infundibulotomy
Ann Thorac Surg
(2000) - et al.
Surgical repair of supposedly multiple defects within the apical part of the muscular ventricular septum
Ann Thorac Surg
(2002) - et al.
Repair of isolated multiple muscular ventricular septal defectsthe septal obliteration technique
Ann Thorac Surg
(2000) - et al.
Repair of large muscular ventricular septal defects in infants employing left ventriculotomy
Ann Thorac Surg
(1989) - et al.
Techniques and results in the management of multiple ventricular septal defects
J Thorac Cardiovasc Surg
(1998) - et al.
Surgical management of isolated multiple ventricular septal defects. Logical approach in 130 cases
J Thorac Cardiovasc Surg
(1992)