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Pamela Burg
Leland Siwek
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J Thorac Cardiovasc Surg 2007;133:1651-1652
© 2007 The American Association for Thoracic Surgery

Brief Communication

Postoperative ventricular septal hematoma: Natural history of two pediatric cases

Richard Jensen, MDa,*, Pamela Burg, MDa, Chris Anderson, MDa, Carl Garabedian, MDa, Hrair Garabedian, MDa, Leland Siwek, MDb, Neil Worrall, MDb

a Northwest Center for Congenital Heart Disease, Sacred Heart Children’s Hospital, Spokane, Wash
b Northwest Heart and Lung Associates, Sacred Heart Children’s Hospital, Spokane, Wash.

Received for publication December 21, 2006; accepted for publication January 2, 2007.

* Address for reprints: Richard Jensen, MD, Northwest Center for Congenital Heart Disease, Sacred Heart Children’s Hospital, 101 West Eighth Ave, Suite 4300, Spokane, WA 99220-2555. (Email: rjensen@nwcchd.com).

The first 20% of the full text of this article appears below.

We describe the case histories of 2 patients less than 6 months of age in whom ventricular septal hematomas developed in the early postoperative period. Both cases were managed expectantly with complete resolution and no long-term sequelae.

Clinical Summaries

Patient 1. The first patient was seen at 2 days of age with poor feeding and a cardiac murmur. An echocardiogram confirmed the diagnosis of type B interrupted aortic arch, posterior malalignment ventricular septal defect (VSD), and ascending aortic hypoplasia. After stabilization, she underwent complete 1-stage surgical repair. With the use of deep hypothermic circulatory arrest, the aortic arch was reconstructed and augmented with pulmonary homograft material. The malaligned VSD was approached through the tricuspid valve. A series of pledget-supported interrupted sutures were placed through the defect margins and a patch of Dacron material secured into position. The patient was weaned from bypass on low-dose dopamine with no rhythm or hemodynamic concerns. Total cardiopulmonary bypass time was 103 minutes. Aortic crossclamp time was 89 minutes. The circulatory arrest time was 43 minutes. A prominent ventricular septal mass with cystic characteristics was noted on postoperative day 1 . . . [Full Text of this Article]






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