Document Detail

Does direct visualization of peripatch areas in beating heart eliminate the risk of residual ventricular septal defect in adult patients?
MedLine Citation:
PMID:  12627071     Owner:  NLM     Status:  MEDLINE    
AIM: Although the incidence of residual ventricular septal defect (VSD) following surgical therapy in the modern series is very low, especially the risk of hemodynamically insignificant shunt still exists. Intraoperative assessment of residual shunt is useful in identifying patients at risk of having subsequently required reoperation and reintervention for residual VSD before chest closure. METHODS: In 87 patients who were operated because of isolated VSD (Group I), VSD was closed under cardioplegic arrest and right atriotomy or right ventriculotomy were closed in the beating heart after aortic cross-clamp removal. The VSD patch was watched out for residual shunt and additional sutures were placed if it existed. Results of this technique have been compared with the other 216 (Group II) in which all procedures of the VSD closure were performed under cardioplegic arrest. Transosephageal echocardiography (TEE) was performed for evidence of residual shunting intraoperatively and postoperatively in all patients. RESULTS: In group I, additional sutures were placed for residual shunt in 14 patients (16.1%), and insignificant residual shunt was detected in only one (1.1%) patient at early postoperative period (p<0.05, according to group II). In group II, there was hemodynamically insignificant residual shunt in 31 patients (14.5%), and 9 patients (4.2%) were reoperated for significant shunt (p<0.05). CONCLUSION: Transatrial or transventricular inspection to peripatch areas in the beating heart is a safe technique to detect a residual shunt, an observation that may eliminate reoperation.
A T Yilmaz
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  44     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-03-10     Completed Date:  2003-06-02     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  51-4     Citation Subset:  IM    
Department of Cardiovascular Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cardiac Surgical Procedures / methods*,  mortality
Echocardiography, Transesophageal
Heart Septal Defects, Ventricular / mortality,  surgery*
Postoperative Complications
Suture Techniques
Treatment Outcome

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

Previous Document:  Role of tetrahydrobiopterin on ischemia-reperfusion injury in isolated perfused rat hearts.
Next Document:  Off-pump coronary artery bypass grafting in a patient with AIDS, acute myocardial infarction, and se...