Apical right ventriculotomy for closure of apical ventricular septal defects

The Annals of Thoracic Surgery
Ulf MyhreGeoffrey L Rosenthal

Abstract

Apical ventricular septal defects (VSDs) are difficult to visualize through a transatrial approach, while the use of a left ventriculotomy may result in progressive ventricular dysfunction. Transcatheter closure has not been reliable, especially in small infants. Apical right ventriculotomy provides good exposure, preserves left ventricular function, and allows secure closure of apical VSDs. From November 1994 through April 2002, nine children, median age 8 months (range, 74 days to 2.5 years) underwent 10 operations for VSD closure via apical right ventriculotomy (one patient with a residual defect underwent successful VSD closure via a second apical right ventriculotomy). Two patients were status post pulmonary artery banding and two patients had previous unsuccessful attempts at closure via a transatrial approach. There was no hospital mortality; there were 2 late deaths (78% survival; 95% confidence interval [CI], 45% to 94%), 3 months and 4 years postoperatively. Postoperative echocardiography demonstrated no residual VSDs in 3 and insignificant residual VSDs in 4 of the survivors. All survivors currently exhibit normal biventricular function during a median follow-up of 25 months (range, 11 to 104 months). Apical right ve...Continue Reading

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Citations

May 7, 2005·The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi·Shin TakabayashiHideto Shimpo
Nov 16, 2011·General Thoracic and Cardiovascular Surgery·Toshihide Asou
Jun 6, 2013·General Thoracic and Cardiovascular Surgery·Tetsuya KitagawaHirotsugu Kurobe
Feb 10, 2016·The Journal of Thoracic and Cardiovascular Surgery·Ryan R Davies
Oct 12, 2010·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·M A Tejero-HernándezE Gómez Guzmán
Mar 31, 2009·The Journal of Thoracic and Cardiovascular Surgery·Naoki YoshimuraTakuro Misaki
Mar 31, 2009·The Journal of Thoracic and Cardiovascular Surgery·Changping GanYingkang Shi
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Jun 3, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ina Michel-BehnkeUNKNOWN Investigators of the Working Group Interventional Cardiology of the German Association of Pediatric Cardiology
Apr 26, 2014·Journal of Cardiac Surgery·Senlin YinQi An
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Mar 21, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ilyas S AleemBrian W McCrindle

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