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A simple surgical technique for closure of apical muscular ventricular septal defect.
J Thorac Cardiovasc Surg 2014; 148(6):2576-9JT

Abstract

OBJECTIVE

Ventricular septal defect (VSD) is among the most common congenital heart diseases encountered in pediatric cardiac patients. Apical muscular VSD constitutes nearly 2% of defects, which may or may not be associated with other congenital heart defects. The purpose of our study is to present our innovative and simple surgical technique using custom-made low-profile polytetrafluoroethylene (PTFE) single disc device for closing multiple apical muscular and isolated apical muscular VSD.

METHOD

Between January 2010 and July 2013, 17 patients with isolated or multiple apical muscular VSDs with or without associated heart diseases underwent operation at our institute. The apical VSD was closed using our custom-made low-profile single disc polytetrafluoroethylene device. The operative technique and the technique used to prepare the single disc device are detailed.

RESULTS

Seventeen patients of ages ranging from 3 months to 7 years underwent operation over 3 years. One 8-month-old patient with transposition of the great arteries with multiple VSDs died after 35 days due to severe pulmonary artery hypertension and sepsis. Another newborn infant with infracardiac total anomalous pulmonary venous connection with a 4-mm apical VSD also died after 3 days because this VSD could not be identified. All other patients are doing well on follow-up.

CONCLUSIONS

The technique described by us has the advantage of apical VSD closure through the left ventricle without left ventriculotomy. Our technique is simple and cost-effective.

Authors+Show Affiliations

Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (affiliated with BJ Medical College, Ahmedabad), Gujarat, India. Electronic address: drmishraamit@yahoo.com.Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (affiliated with BJ Medical College, Ahmedabad), Gujarat, India.Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (affiliated with BJ Medical College, Ahmedabad), Gujarat, India.Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (affiliated with BJ Medical College, Ahmedabad), Gujarat, India.Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (affiliated with BJ Medical College, Ahmedabad), Gujarat, India.Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (affiliated with BJ Medical College, Ahmedabad), Gujarat, India.Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (affiliated with BJ Medical College, Ahmedabad), Gujarat, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24667025

Citation

Mishra, Amit, et al. "A Simple Surgical Technique for Closure of Apical Muscular Ventricular Septal Defect." The Journal of Thoracic and Cardiovascular Surgery, vol. 148, no. 6, 2014, pp. 2576-9.
Mishra A, Shah R, Desai M, et al. A simple surgical technique for closure of apical muscular ventricular septal defect. J Thorac Cardiovasc Surg. 2014;148(6):2576-9.
Mishra, A., Shah, R., Desai, M., Chourasiya, A., Patel, H., Oswal, N., & Rodricks, D. (2014). A simple surgical technique for closure of apical muscular ventricular septal defect. The Journal of Thoracic and Cardiovascular Surgery, 148(6), pp. 2576-9. doi:10.1016/j.jtcvs.2014.02.036.
Mishra A, et al. A Simple Surgical Technique for Closure of Apical Muscular Ventricular Septal Defect. J Thorac Cardiovasc Surg. 2014;148(6):2576-9. PubMed PMID: 24667025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A simple surgical technique for closure of apical muscular ventricular septal defect. AU - Mishra,Amit, AU - Shah,Ritesh, AU - Desai,Manan, AU - Chourasiya,Ajay, AU - Patel,Hardik, AU - Oswal,Nilesh, AU - Rodricks,Dayesh, Y1 - 2014/02/14/ PY - 2013/09/27/received PY - 2014/02/04/revised PY - 2014/02/10/accepted PY - 2014/3/27/entrez PY - 2014/3/29/pubmed PY - 2015/1/24/medline SP - 2576 EP - 9 JF - The Journal of thoracic and cardiovascular surgery JO - J. Thorac. Cardiovasc. Surg. VL - 148 IS - 6 N2 - OBJECTIVE: Ventricular septal defect (VSD) is among the most common congenital heart diseases encountered in pediatric cardiac patients. Apical muscular VSD constitutes nearly 2% of defects, which may or may not be associated with other congenital heart defects. The purpose of our study is to present our innovative and simple surgical technique using custom-made low-profile polytetrafluoroethylene (PTFE) single disc device for closing multiple apical muscular and isolated apical muscular VSD. METHOD: Between January 2010 and July 2013, 17 patients with isolated or multiple apical muscular VSDs with or without associated heart diseases underwent operation at our institute. The apical VSD was closed using our custom-made low-profile single disc polytetrafluoroethylene device. The operative technique and the technique used to prepare the single disc device are detailed. RESULTS: Seventeen patients of ages ranging from 3 months to 7 years underwent operation over 3 years. One 8-month-old patient with transposition of the great arteries with multiple VSDs died after 35 days due to severe pulmonary artery hypertension and sepsis. Another newborn infant with infracardiac total anomalous pulmonary venous connection with a 4-mm apical VSD also died after 3 days because this VSD could not be identified. All other patients are doing well on follow-up. CONCLUSIONS: The technique described by us has the advantage of apical VSD closure through the left ventricle without left ventriculotomy. Our technique is simple and cost-effective. SN - 1097-685X UR - https://www.unboundmedicine.com/medline/citation/24667025/A_simple_surgical_technique_for_closure_of_apical_muscular_ventricular_septal_defect_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(14)00196-2 DB - PRIME DP - Unbound Medicine ER -