Current topics in surgery for multiple ventricular septal defects

Naoki Yoshimura*, Kazuaki Fukahara, Akio Yamashita, Yoshinori Doki, Katsunori Takeuchi, Tomonori Higuma, Kazutaka Senda, Masayoshi Toge, Tatsuro Matsuo, Saori Nagura, Masaya Aoki, Kimimasa Sakata, Mari Sakai

*この論文の責任著者

研究成果: ジャーナルへの寄稿総説査読

5 被引用数 (Scopus)

抄録

In this review article, we describe several topics, including the sandwich technique, the transatrial re-endocardialization technique, the limited apical left ventriculotomy approach and device closure. The sandwich technique was introduced for the closure of muscular ventricular septal defects (VSD) by sandwiching the septum between two felt patches placed in the left and right ventricle. This technique requires neither the transection of muscular trabeculae nor ventriculotomy. Although the sandwich technique has resulted in the improvement of surgical outcomes, cases of postoperative cardiac dysfunction have been reported. Multiple smaller VSDs have been closed with transatrial re-endocardialization. Septal dysfunction may be avoided through this technique, in which the septal trabeculae are approximated in two layers of superficial, endocardial running sutures. Recently, a number of reports have recommended a limited apical left ventriculotomy approach. With this technique, a much shorter incision of around 1 cm at the apex of the left ventricle may be sufficient for achieving the complete closure of apical muscular VSDs. The transcatheter or perventricular device closure of muscular VSDs has increasingly been performed with good results. Although favorable early and mid-term results of device closure have been reported, this method is not always safer or less invasive than surgical closure. Long-term evaluations should be performed to determine whether the right and left ventricular functions are affected by treatment with relatively large devices in the heart.

本文言語英語
ページ(範囲)393-397
ページ数5
ジャーナルSurgery Today
46
4
DOI
出版ステータス出版済み - 2016/04/01

ASJC Scopus 主題領域

  • 外科

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