Surgical closure of apical multiple muscular septal defects via right ventriculotomy using a single patch with intermediate fixings  

作　　者：LI Gang WANG Qiang LIU Ying-long XU Yu-lin GUO Yan 

机构地区：[1]Capital Med Univ, Anzhen Hosp, Paediat Heart Ctr, Beijing 100029, Peoples R China [2]Chinese Acad Med Sci, Paediat Ctr Cardiac Surg, Cardiovasc Inst, Beijing 100037, Peoples R China [3]Chinese Acad Med Sci, Fu Wai Hosp, Beijing 100037, Peoples R China [4]Peking Union Med Coll, Beijing 100037, Peoples R China

出　　处：《Chinese Medical Journal》2013年第15期2866-2870,共5页中华医学杂志（英文版）

摘　　要：Background Multiple apical muscular ventricular septal defects （VSDs） remain a challenge for surgeons because of their anatomical features. We used single patch with intermediate fixations to repair multiple apical muscular VSDs through right ventricuiotomy. Methods We analysed the data of 16 children （median age 8 months, range 2 months to 144 months） with multiple apical muscular VSDs who underwent a single patch technique via apical right ventdcu^otomy. Perioperative data were collected and analysed, and the patients were followed up for three months to 66 months （median, 46 months） to investigate the outcomes. Results All patients recovered from cardiopulmonary bypass easily with median of cardiopulmonary bypass time 87 minutes and of aortic crossclamp time 53 minutes. No surgically related death occurred and no patient required reoperation. One patient died of pseudomonas pyocyanea infection on day 11 postoperatively. Residual shunt happened in one patient with a diameter of 2 mm and spontaneously closed in 12 months after operation. Two patients presented slightly reduced right ventricular volume and apical hypokinesia postoperatively and recovered 24 and 36 months later respectively. No other complication was found during the three months to 66 months follow-up. Conclusion Our experiences using a single patch technique with intermediate fixations via right ventriculotomy in the management of multiple muscular VSDs had favourable outcomes.Background Multiple apical muscular ventricular septal defects （VSDs） remain a challenge for surgeons because of their anatomical features. We used single patch with intermediate fixations to repair multiple apical muscular VSDs through right ventricuiotomy. Methods We analysed the data of 16 children （median age 8 months, range 2 months to 144 months） with multiple apical muscular VSDs who underwent a single patch technique via apical right ventdcu^otomy. Perioperative data were collected and analysed, and the patients were followed up for three months to 66 months （median, 46 months） to investigate the outcomes. Results All patients recovered from cardiopulmonary bypass easily with median of cardiopulmonary bypass time 87 minutes and of aortic crossclamp time 53 minutes. No surgically related death occurred and no patient required reoperation. One patient died of pseudomonas pyocyanea infection on day 11 postoperatively. Residual shunt happened in one patient with a diameter of 2 mm and spontaneously closed in 12 months after operation. Two patients presented slightly reduced right ventricular volume and apical hypokinesia postoperatively and recovered 24 and 36 months later respectively. No other complication was found during the three months to 66 months follow-up. Conclusion Our experiences using a single patch technique with intermediate fixations via right ventriculotomy in the management of multiple muscular VSDs had favourable outcomes.

关 键 词：PAEDIATRIC muscular septal defects SURGERY 

分 类 号：S725.2[农业科学—林木遗传育种] Q132.3[农业科学—林学]