Document Detail


Closure of muscular ventricular septal defects through a left ventriculotomy.
MedLine Citation:
PMID:  8875164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the results of closure of muscular ventricular septal defects through a left thoracotomy. METHODS: Records of 23 children operated consecutively between 1972 and 1990 were studied. Age of patients was 2.8 +/- 3 years (2 months-10 years), weight 8.9 +/- 5.7 kg (2.6-22 kg). Ten patients (43%) had undergone one and 4 patients (17%) two previous cardiac operations. Late follow-up was obtained from direct examination of patients or from reports of their referring physicians. Bypass time was 89 +/- 28 min (66-167 min). The aorta was cross-clamped for 44 +/- 15 min (21-66 min). Until 1977 operations were performed with moderate hypothermia and intermittent aortic cross-clamping. After 1978 deep hypothermia (20-25 degrees C) and cold crystalloid cardioplegia was used. Ventricular septal defects not accessible from other approaches were closed through a small fish-mouth incision in the apex of the left ventricle. Patients' data were sampled and stored in a computerised database. Risk factors were evaluated by stepwise logistic regression. RESULTS: Four patients died in the hospital (17%); two died later. Two required reoperation for residual/recurrent defects. All patients, except two from abroad, were available for follow-up, which ranged from 36 months to 18 years (mean 11.3 years). All were in NYHA class I. Only two risk factors were identified: the number of ventricular septal defects (P < 0.05) and associated atrial septal defect (P < 0.02). Early echocardiographic evaluation showed good LV size and function in all except one patient, who had a perioperative septal infarction. Late echocardiography performed in six patients demonstrated normal LV shortening without evidence of regional wall abnormality. CONCLUSIONS: Left ventriculotomy is a useful approach for closure of low muscular ventricular septal defects in selected patients.
Authors:
G Wollenek; R Wyse; I Sullivan; M Elliott; M de Leval; J Stark
Related Documents :
856084 - Posterior rupture of the interventricular septum after acute myocardial infarction: suc...
8501554 - Transtelephonic echocardiography: successful use in a tertiary pediatric referral center.
16649234 - Late complete atriovenous block after percutaneous closure of a perimembranous ventricu...
2541614 - Cytochrome-c-oxidase deficient cardiomyocytes in the human heart--an age-related phenom...
17569804 - A quantitative estimate of bare-metal stenting compared with balloon angioplasty in pat...
7614544 - Safety of coronary ultrasound angioplasty: effects of sonication on intact canine coron...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  10     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1996  
Date Detail:
Created Date:  1997-01-17     Completed Date:  1997-01-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  595-8     Citation Subset:  IM    
Affiliation:
Great Ormond Street Hospital for Children NHS Trust, London, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / methods*
Child
Child, Preschool
Evaluation Studies as Topic
Female
Follow-Up Studies
Heart Catheterization
Heart Septal Defects, Ventricular / diagnosis,  physiopathology,  surgery*
Humans
Infant
Male
Postoperative Complications / physiopathology*
Risk Factors
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Monte Carlo results for the 3-poly test for animal carcinogenicity experiments.
Next Document:  Relationships between the dimensions of the human aortic and pulmonary valve leaflets: implications ...