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J Thorac Cardiovasc Surg 2009;137:779-780
© 2009 The American Association for Thoracic Surgery

Brief Communication

Left atrial hybrid closure of muscular ventricular septal defects with the Amplatzer device

Christopher W. Baird, MD*, Herbert Stern, MD, Larry Watts, MD

Levine Children's Hospital, Carolinas Healthcare System, the Sanger Clinic, Charlotte, NC

Received for publication December 17, 2007; revisions received February 22, 2008; accepted for publication March 23, 2008.

* Address for reprints: Christopher W. Baird, MD, Cardiovascular Surgery, Levine Children's Hospital, Carolinas Healthcare System, 1001 Blythe Blvd, Suite 300, Charlotte, NC 28205. (Email: cbaird@sanger-clinic.com).

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

Muscular ventricular septal defects (mVSDs), whether dealt with as a single lesion or as a complex of congenital heart disease, are fraught with difficulty. Pulmonary artery bands are palliative, and ventriculotomies initiate scarring. Simple single mVSDs are difficult to visualize from a right atrial approach because they are commonly in the apex, whereas multiple mVSDs have muscular septations within the right ventricular cavity, making it difficult to visualize a defined edge for optimal patch opposition, leaving residual shunts. Transcatheter occluders have been placed in the ventricular septum percutaneously,1Go perventricularly,2,3Go and intraoperatively.4Go In general, a significant amount of experience and resources are necessary to perfect the percutaneous/perventricular techniques, whereas the direct intraoperative approach is more straightforward. Furthermore, cardiopulmonary bypass (CPB) is often necessary for other associated complex congenital lesions. We present a simple hybrid-type approach to close mVSDs during cardioplegic arrest using an Amplatzer duct occluders (AGA Medical, Golden Valley, Minn) through the left atrium in a patient with D-transposition of the great arteries.

Clinical Summary

After dissection of . . . [Full Text of this Article]






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