| Closure of muscular ventricular septal defects through a left ventriculotomy. | |
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MedLine Citation:
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PMID: 8875164 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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G Wollenek; R Wyse; I Sullivan; M Elliott; M de Leval; J Stark |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 1997-01-17 Completed Date: 1997-01-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: NETHERLANDS |
Other Details:
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Languages: eng Pagination: 595-8 Citation Subset: IM |
Affiliation:
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Great Ormond Street Hospital for Children NHS Trust, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Surgical Procedures
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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
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