HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Emile A. Bacha Joanne P. Starr Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bacha, E. A. Articles by Hijazi, Z. M. Search for Related Content PubMed PubMed Citation Articles by Bacha, E. A. Articles by Hijazi, Z. M. Related Collections Minimally invasive surgery

J Thorac Cardiovasc Surg 2003;126:1718-1723
© 2003 The American Association for Thoracic Surgery

Surgery for congenital heart disease

Perventricular device closure of muscular ventricular septal defects on the beating heart: technique and results

^a Sections of Cardiothoracic Surgery, Pediatric and Congenital Cardiac Surgery, Chicago, Ill, USA
^b Pediatric Cardiology, Chicago, Ill, USA
^c Pediatric Cardiology, The University of Mississippi Medical Center, Jackson, Miss, USA

Received for publication February 17, 2003; revisions received April 18, 2003; accepted for publication June 17, 2003.

^* Address for reprints: Emile A. Bacha, MD, Pediatric and Congenital Cardiac Surgery, The University of Chicago Children's Hospital, 5841 S Maryland Ave, MC 5040, Chicago, IL, USA 60637
ebacha{at}surgery.bsd.uchicago.edu

OBJECTIVE: Both surgical management and percutaneous device closure of muscular ventricular septal defects have drawbacks and limitations. This report describes our initial experience with intraoperative device closure of muscular ventricular septal defects without cardiopulmonary bypass in 6 consecutive patients.

METHODS: A median sternotomy or a subxiphoid minimally invasive incision was performed. Under continuous transesophageal echocardiographic guidance, the right ventricle free wall was punctured, and a wire was introduced across the largest defect. The Amplatzer (AGA Medical Corporation, Golden Valley, Minn) muscular ventricular septal defect occluding device (a self-expandable double-disk device) was used. An introducer sheath was fed over the wire, with the sheath tip positioned in the left ventricle cavity. The device was then advanced inside the sheath and deployed by retracting the sheath. Associated cardiac lesions, if any, can then be repaired during cardiopulmonary bypass. A similar technique can also be applied for periatrial closure of complex atrial septal defects.

RESULTS: The initial 6 patients are presented. Cardiopulmonary bypass was not needed in any patient for placement of the device and needed in 4 patients for repair of concomitant malformations only (double-outlet right ventricle, aortic arch hypoplasia, pulmonary artery band removal). No complications from using this technique occurred. Discharge echocardiograms showed no significant shunting across the ventricular septum.

CONCLUSIONS: Perventricular closure of multiple muscular ventricular septal defects is safe and effective. We believe that this could become the treatment of choice for any infant with muscular ventricular septal defects or any child with muscular ventricular septal defect and associated cardiac defects.

This article has been cited by other articles:

				C. Gan, Q. An, K. Lin, H. Tang, R. C. Lui, K. Tao, W. Pan, and Y. Shi Perventricular device closure of ventricular septal defects: six months results in 30 young children. Ann. Thorac. Surg., July 1, 2008; 86(1): 142 - 146. [Abstract] [Full Text] [PDF]

				N. V. Vasilyev, P. M. Novotny, J. F. Martinez, H. Loyola, I. S. Salgo, R. D. Howe, and P. J. del Nido Stereoscopic vision display technology in real-time three-dimensional echocardiography-guided intracardiac beating-heart surgery. J. Thorac. Cardiovasc. Surg., June 1, 2008; 135(6): 1334 - 1341. [Abstract] [Full Text] [PDF]

				R. Kozlik-Feldmann, N. Lang, R. Aumann, A. Lehner, D. Rassoulian, R. Sodian, C. Schmitz, M. Hinterseer, R. Hinkel, E. Thein, et al. Patch closure of muscular ventricular septal defects with a new hybrid therapy in a pig model. J. Am. Coll. Cardiol., April 22, 2008; 51(16): 1597 - 1603. [Abstract] [Full Text] [PDF]

				N. V. Vasilyev, I. Melnychenko, K. Kitahori, F. P. Freudenthal, A. Phillips, R. Kozlik-Feldmann, I. S. Salgo, P. J. del Nido, and E. A. Bacha Beating-heart patch closure of muscular ventricular septal defects under real-time three-dimensional echocardiographic guidance: A preclinical study J. Thorac. Cardiovasc. Surg., March 1, 2008; 135(3): 603 - 609. [Abstract] [Full Text] [PDF]

				X. J. Zeng, S. Q. Sun, X. F. Chen, X. J. Ma, Y. H. Luo, Y. P. Lim, and L. Tao Device Closure of Perimembranous Ventricular Septal Defects With a Minimally Invasive Technique in 12 Patients Ann. Thorac. Surg., January 1, 2008; 85(1): 192 - 194. [Abstract] [Full Text] [PDF]

				A. Kulik, M. Labinaz, L. M. Beauchesne, D. Nicholson, and P. Bedard Hybrid repair of mitral paravalvular leak: Open surgical placement of a percutaneous occluder device J. Thorac. Cardiovasc. Surg., December 1, 2006; 132(6): 1469 - 1470. [Full Text] [PDF]

				B. Alsoufi, T. Karamlou, M. Osaki, M. V. Badiwala, C. C. Ching, A. Dipchand, B. W. McCrindle, J. G. Coles, C. A. Caldarone, W. G. Williams, et al. Surgical repair of multiple muscular ventricular septal defects: the role of re-endocardialization strategy. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1072 - 1080. [Abstract] [Full Text] [PDF]

				Z. Amin, R. Woo, D. A. Danford, S. E. Froemming, V. M. Reddy, J. Lof, and D. Overman Robotically assisted perventricular closure of perimembranous ventricular septal defects: Preliminary results in Yucatan pigs J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 427 - 432. [Abstract] [Full Text] [PDF]

				D. G. Pennington The Impact of New Technology on Cardiothoracic Surgical Practice Ann. Thorac. Surg., January 1, 2006; 81(1): 10 - 18. [Full Text] [PDF]

				K. A. Diab, Z. M. Hijazi, Q.-L. Cao, and E. A. Bacha A truly hybrid approach to perventricular closure of multiple muscular ventricular septal defects J. Thorac. Cardiovasc. Surg., September 1, 2005; 130(3): 892 - 892. [Full Text] [PDF]

				M. Pawelec-Wojtalik, L. K. von Segesser, M. Liang, and D. Bukowska Closure of left ventricle perforation with the use of muscular VSD occluder Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 714 - 716. [Abstract] [Full Text] [PDF]

				M. Pawelec-Wojtalik, P. Antosik, G. Wasiatycz, and M. Wojtalik Use of muscular VSD Amplatzer occluder for closing right ventricular free wall perforation after hybrid procedure Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 1044 - 1046. [Abstract] [Full Text] [PDF]

				T. P. Graham Jr The year in congenital heart disease J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2132 - 2141. [Full Text] [PDF]

				R. Holzer, D. Balzer, Q.-L. Cao, K. Lock, Z. M. Hijazi, and Amplatzer Muscular Ventricular Septal Defect Inves Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder: Immediate and mid-term results of a U.S. registry J. Am. Coll. Cardiol., April 7, 2004; 43(7): 1257 - 1263. [Abstract] [Full Text] [PDF]