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The Journal of Thoracic and Cardiovascular Surgery, Vol 78, 515-526, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
MR de Leval, P Bastos, J Stark, JF Taylor, FJ Macartney and RH Anderson
Traumatic heart block remains a major concern after ventricular septal
defect (VSD) closure in patients with atrioventricular discordance. A
technique of closing the VSD, placing the suture line on the
morphologically right side of the septum without opening the systemic
ventricle, is described. This was used in 13 consecutive patients. The VSD
was closed through the right atrium in eight patients, the left ventricle
in three patients, the right atrium and the left ventricle in one patient,
and through the right ventricle in one patient with atrioventricular
disordance and ventriculo-arterial concordance. All patients were in sinus
rhythm preoperatively, two exhibited atrioventricular dissociation before
intracardiac manipulation began, and 11 patients were in sinus rhythm
postoperatively. No major arrhythmia could be attributed to the closure of
the VSD.
ARTICLES
Surgical technique to reduce the risks of heart block following closure of ventricular septal defect in atrioventricular discordance
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