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Fulltext Surgical management of recurrent postinfarction ventricular septal defect

Eng JB

Med J Malaysia, 2007 Aug;62(3):261-2.
PMID: 18246924 MyJurnal

A 57 year old man presented with postinfarction ventricular septal infarct (VSD) a week after myocardial infarction and thrombolytic therapy. Coronary angiography confirmed double vessel disease. He underwent surgical repair of the VSD and coronary artery bypass grafting. Two days postoperatively, he deteriorated due to recurrence of VSD. Reoperation was carried out with satisfactory results. The surgical management is described with a review of the relevant literature.

Matched MeSH terms: Heart Septal Defects, Ventricular/surgery*
Transcatheter closure of muscular ventricular septal defect using the Amplatzer devices

Djer MM, Latiff HA, Alwi M, Samion H, Kandavello G

Heart Lung Circ, 2006 Feb;15(1):12-7.
PMID: 16473785

From November 1997 to June 2002, percutaneous transcatheter closure of muscular ventricular septal defects was attempted in seven patients. Four patients had single and three had multiple defects. Surgical closure was performed in two patients in an attempt to close a perimembranous defect, leaving behind a large apical muscular defect, which was successfully closed using a device in one patient, whilst the second patient succumbed to septicemia/endocarditis 3 weeks after failure of device implantation. One patient had previous pulmonary artery banding and in another intraoperative placement of two Clamshell devices followed by additional transcatheter closure using Gianturco coils in two different sessions was performed.

Matched MeSH terms: Heart Septal Defects, Ventricular/surgery*
Strategy for ventricular septal defect closure after prior gastric pull-through

Sivalingam S, Krishnasamy S, Yakub MA

Asian Cardiovasc Thorac Ann, 2015 Jun;23(5):612-4.
PMID: 24962807 DOI: 10.1177/0218492314540667

A 9-year-old boy was referred with a perimembranous ventricular septal defect. At birth, he had undergone a right thoracotomy with ligation of a tracheoesophageal fistula, cervical esophagostomy, and feeding gastrostomy. At 2 years of age, he had gastric tube reconstruction with a pull-through retrosternally, anterior to the heart, and an end-to-end esophagogastric anastomosis. Via a right anterolateral thoracotomy through the previous scar, the entire gastric tube was mobilized away from the sternum to facilitate a median sternotomy. With the patient supine, a median sternotomy was performed without difficulty, and the ventricular septal defect was closed under cardiopulmonary bypass.

Matched MeSH terms: Heart Septal Defects, Ventricular/surgery*
Surgery for doubly committed ventricular septal defects

Shamsuddin AM, Chen YC, Wong AR, Le TP, Anderson RH, Corno AF

Interact Cardiovasc Thorac Surg, 2016 Aug;23(2):231-4.
PMID: 27170744 DOI: 10.1093/icvts/ivw129

OBJECTIVES: Doubly committed ventricular septal defects (VSDs) account for up to almost one-third of isolated ventricular septal defects in Asian countries, compared with only 1/20th in western populations. In our surgical experience, this type of defect accounted for almost three-quarters of our practice. To date, patch closure has been considered the gold standard for surgical treatment of these lesions. Our objectives are to evaluate the indications and examine the outcomes of surgery for doubly committed VSDs.
METHODS: Between October 2013, when our service of paediatric cardiac surgery was opened, and December 2014, 24 patients were referred for surgical closure of VSDs. Among them, 17 patients (71%), with the median age of 6 years, ranging from 2 to 9 years, and with a median body weight of 19 kg, ranging from 11 to 56 kg, underwent surgical repair for doubly committed defects. In terms of size, the defect was considered moderate in 4 and large in 13. Aortic valvular regurgitation (AoVR) was present in 11 patients (65%) preoperatively, with associated malformations found in 14 (82%), with 5 patients (29%) having two or more associated defects.
RESULTS: After surgery, there was trivial residual shunting in 2 patients (12%). AoVR persisted in 6 (35%), reducing to trivial in 5 (29%) and mild in 1 (6%). Mean stays in the intensive care unit and hospital were 2.6 ± 1.2 days, ranging from 2 to 7 days, and 6.8 ± 0.8 days, ranging from 6 to 9 days, respectively. The mean follow-up was 14 ± 4 months, ranging from 6 to 20 months, with no early or late deaths and without clinical deterioration.
CONCLUSIONS: The incidence of doubly committed lesions is high in our experience, frequently associated with AoVR and other associated malformation. Early detection is crucial to prevent further progression of the disease. Patch closure remains the gold standard in management, not least since it allows simultaneous repair of associated intracardiac defects.

Matched MeSH terms: Heart Septal Defects, Ventricular/surgery*
Myocardial Rupture Secondary to Ventricular Septal Hematoma: A Case Report and Review of Contemporary Literature

Haranal M, Hew CC, Dillon JJ

World J Pediatr Congenit Heart Surg, 2019 11;10(6):793-795.
PMID: 31701824 DOI: 10.1177/2150135119872202

Interventricular septal hematoma following congenital cardiac surgery is an uncommon entity. Literature search reveals few cases of interventricular septal hematoma complicating pediatric cardiac surgery. We report a case of interventricular septal hematoma following patch closure of ventricular septal defect, with associated myocardial necrosis and myocardial rupture.

Matched MeSH terms: Heart Septal Defects, Ventricular/surgery*