| Closing perimembranous ventricular septal defects in adult patients in the beating heart. | |
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MedLine Citation:
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PMID: 12220066 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Although the incidence of complete heart block and residual shunt following closure of ventricular septal defects is very low in modern series, the risk of these complications still exists. Closing the inferior margin of a perimembranous VSD in the beating heart, may in some cases, be a safe technique which eliminates the risk of atrioventricular block and residual shunt. METHODS: In 17 patients operated on for isolated VSD (Group I), the inferior margin of the defect was closed in the beating heart. The results of this technique have been compared with another 158 patients (Group II) in whom the VSD was closed under cardioplegic arrest. RESULTS: In Group I complete atrioventricular block developed during the placing or tying down of the sutures in 2 patients (11.7%). Normal sinus rhythm returned in 2 minutes following removing and replacement. Additional sutures were placed for residual shunt in 3 patients (17.6%). Of the 158 patients in Group II, there was complete atrioventricular block in 12 (7.5%) in the early postoperative period, and 4 (2.5%) later required a permanent pacemaker. Endocarditis prophylaxis was given to 13 patients (8.2%) because of hemodynamically insignificant residual shunts. Three patients (1.9%) were reoperated for a significant shunt. CONCLUSIONS: Closing the inferior margin of a perimembranous VSD in the beating heart is a safe technique which eliminates the risk of atrioventricular block and residual shunt. |
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Authors:
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Ertugrul Ozal; Ahmet Turan Yilmaz; Mehmet Arslan; Nadir Barindik; Bilgehan Savas Oz; Harun Tatar |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 17 ISSN: 0886-0440 ISO Abbreviation: J Card Surg Publication Date: 2002 Mar-Apr |
Date Detail:
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Created Date: 2002-09-10 Completed Date: 2003-01-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 143-7 Citation Subset: IM |
Affiliation:
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Gulhane Military Medical Academy, Department of Cardiovascular Surgery, Ankara, Turkey. ozals@tr.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Cardiovascular Surgical Procedures* Echocardiography, Transesophageal Electrocardiography Female Follow-Up Studies Heart Conduction System / surgery Heart Septal Defects, Ventricular / epidemiology, surgery* Hemodynamics / physiology Humans Incidence Male Postoperative Complications / epidemiology, etiology Survival Analysis Suture Techniques Treatment Outcome Ventricular Function, Left / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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