scholarly journals Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Qin Wu ◽  
Lei Shi ◽  
Rui Chen ◽  
Quansheng Xing
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Surgical Repair ◽  
Major Complication ◽  
Long Term Results ◽  
Swiss Cheese ◽  
Ventricular Septal Defects ◽  
Autologous Pericardium ◽  
Septal Defects ◽  
The Right

Abstract Background “Swiss Cheese” ventricular septal defects (VSDs) is a kind of rare and complex congenital heart defects and the surgical management remains controversial and a challenge. We reviewed our preliminary clinical experience on biventricular surgical repair of “Swiss Cheese” VSDs with two-patch and right ventricle apex excluding technique in 10 cases. Methods From May 2014 to December 2019, a series of 10 patients (M/F = 3/7) were admitted in our center. Nine cases underwent one-stage surgical repair with two-patch and right ventricle apex excluding technique and 1 case received two-stage surgical repair with the same technique. Surgical repair was done with cardiopulmonary bypass (CPB) in all cases. Two fresh autologous pericardium patches were used to close defects of the outflow tract area and the apex trabecular area respectively and as a result, the right ventricular apex was excluded from the right ventricular inflow tract. Results All operations were successful. Median CPB time and aortic clamping time were 96 min and 68 min respectively. Delayed chest closure was performed in 2 cases within 48–72 h postoperatively. The Median time of mechanical ventilation and ICU stay were 131.3 h and 8 days respectively. Median length of hospital stay after operation was 11 (9–42) days. There was no mortality and major complication except for 2 cases of ventilator associated pneumonia. There was no death and major complication during a median follow-up time of 3.2 years.. The latest echocardiography results showed the left and right heart function was normal in all the cases. Conclusions Biventricular surgical repair of “Swiss Cheese” VSDs with two-patch of fresh autologous pericardium and right ventricle apex excluding technique in infants is safe and feasible with favorable early and mid-term results. Long term results need to be evaluated with more cases.

scholarly journals Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

2021 ◽  
Author(s):  
Qin Wu ◽  
Lei Shi ◽  
Rui Chen ◽  
Quansheng Xing
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Surgical Repair ◽  
Major Complication ◽  
Long Term Results ◽  
Swiss Cheese ◽  
Ventricular Septal Defects ◽  
Autologous Pericardium ◽  
Septal Defects ◽  
The Right

Abstract Background “Swiss Cheese” ventricular septal defects (VSDs) is a kind of rare and complex congenital heart defects and the surgical management remains controversial and a challenge. We reviewed our preliminary clinical experience on biventricular surgical repair of “Swiss Cheese” VSDs with two-patch and right ventricle apex excluding technique in 10 cases.Methods From May 2014 to December 2019, a series of 10 patients (M/F=3/7) were admitted in our center. 9 cases underwent one-stage surgical repair with two-patch and right ventricle apex excluding technique and 1 case received two-stage surgical repair with the same technique. Surgical repair was done with cardiopulmonary bypass (CPB) in all cases. 2 fresh autologous pericardium patches were used to close defects of the outflow tract area and the apex trabecular area respectively and as a result, the right ventricular apex was excluded from the right ventricular inflow tract.Results All operations were successful. Median CPB time and aortic clamping time were 96 min and 68 min respectively. Delayed chest closure was performed in 2 cases within 48-72 hours postoperatively. The Median time of mechanical ventilation and ICU stay were 131.3 hours and 8 days respectively. Median length of hospital stay after operation was 11 （9-42）days. There was no mortality and major complication except for 2 cases of ventilator associated pneumonia. There was no death and major complication during a median follow-up time of 3.2 years.. The latest echocardiography results showed the left and right heart function was normal in all the cases.Conclusions Biventricular surgical repair of “Swiss Cheese” VSDs with two-patch of fresh autologous pericardium and right ventricle apex excluding technique in infants is safe and feasible with favorable early and mid-term results. Long term results need to be evaluated with more cases.

scholarly journals Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results

2020 ◽  
Author(s):  
Qin Wu ◽  
Lei Shi ◽  
Rui Chen ◽  
Quansheng Xing
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Surgical Repair ◽  
Major Complication ◽  
Long Term Results ◽  
Swiss Cheese ◽  
Ventricular Septal Defects ◽  
Autologous Pericardium ◽  
Septal Defects ◽  
The Right

Abstract Background “Swiss Cheese” ventricular septal defects (VSDs) is a kind of rare and complex congenital heart defects and the surgical management remains controversial and a challenge. We reviewed our preliminary clinical experience on biventricular surgical repair of “Swiss Cheese” VSDs with two-patch and right ventricle apex excluding technique in 10 cases. Methods From May 2014 to December 2019, a series of 10 patients (M/F=3/7) were admitted in our center. 9 cases underwent one-stage surgical repair with two-patch and right ventricle apex excluding technique and 1 case received a second-stage surgical repair with the same technique. Surgical repair was done with cardiopulmonary bypass (CPB) in all cases. 2 fresh autologous pericardium patches were used to close defects of the outflow tract area and the apex trabecular area respectively and as a result, the right ventricular apex was excluded from the right ventricular inflow tract. Results All the operations were successful. Median CPB time and aortic clamping time were 96 min and 68 min respectively. Delayed chest closure were done in 2 cases within 48-72 hours postoperatively. The Median time of mechanical ventilation and ICU stay were 131.3 hours and 8 days respectively. Median length of stay after operation was 11 （9-42）days. There was no mortality and major complication except for 2 cases of ventilator associated pneumonia. There was no death and major complication during the median follow-up time of 3.2 years.. The latest echocardiography results showed the left and right heart function was normal in all the cases. Conclusions Biventricular surgical repair of “Swiss Cheese” VSDs with two-patch of fresh autologous pericardium and right ventricle apex excluding technique in infants is safe and feasible with favorable early and mid-term results. Long term results need to be evaluated with more cases.

scholarly journals Repair of double-chambered right ventricle using right ventricular outflow chamber ventriculotomy via left intercostal thoracotomy under beating heart in two dogs

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Keiichi Sato ◽  
Isamu Kanemoto ◽  
Kippei Mihara ◽  
Koudai Kawase ◽  
Takuya Mori ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Continuous Wave ◽  
Clinical Signs ◽  
Major Complication ◽  
Beating Heart ◽  
Moderate Hypothermia ◽  
Continuous Wave Doppler ◽  
Novel Approach ◽  
The Right

Double-chambered right ventricle was diagnosed in two dogs, one of them a pup and the other full grown. Both dogs underwent surgery using the novel approach of right ventricular outflow chamber ventriculotomy via left intercostal thoracotomy with moderate hypothermia and moderate pump flow cardiopulmonary bypass under beating heart. No major complication occurred during and after the operation. On continuous wave Doppler echocardiography, the pressure gradient across the stenosis in the right ventricle decreased from 130 mmHg pre-operatively to 40 mmHg post-operatively at 1 year 5 months in the adult dog, and from 209 mmHg pre-operatively to 47 mmHg post-operatively at 1 year in the pup. Both dogs are active without clinical signs.

scholarly journals Late follow-up of Persistent Truncus Arteriosus, after one-stage Repair, with Right Ventricular Remodeling.

2021 ◽  
Vol 4 (5) ◽  
pp. 01-04
Author(s):  
Miguel Maluf
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Remodeling ◽  
Surgical Repair ◽  
Pulmonary Valve ◽  
Truncus Arteriosus ◽  
Persistent Truncus Arteriosus ◽  
The Right ◽  
Right Ventricular Remodeling

We report long-term outcome after one-stage, surgical repair, in a two months-old girl with persistent truncus arteriosus type I, II. The operation was carried out with the remodeling of the right ventricle, using a swine bicuspid pulmonary prosthesis. Twenty-six years later, the patient is in excellent clinical condition, CF I (NYHA), with normal peripheral oxygen saturation. Recent invasive and not invasive imaging show: absence of intracardiac shunt and growing of the right ventricle outlet tract and discrete double lesion of the pulmonary valve. The pulmonary flow directed uniformly for both lungs. In selected cases, the long-term prognosis of patients with persistent truncus arteriosus, undergoing early surgical repair, avoiding the use of valved conduit, makes for an excellent evolution, without new interventions. Endovascular procedures, now well standardized, for the implantation of a pulmonary valve stent, through a catheter, will allow an effective approach, in the presence of late obstructions, in patients who have undergone right ventricular remodeling, without the use of valved conduits.

The echocardiographic anatomy of ventricular septal defects

1997 ◽  
Vol 7 (4) ◽  
pp. 471-484 ◽  
Author(s):  
Michael A. Gatzoulis ◽  
Jia Li ◽  
Siew Yen Ho
Keyword(s):  
Right Ventricle ◽  
Atrioventricular Conduction ◽  
Ventricular Septal Defects ◽  
Cross Sectional ◽  
Septal Defects ◽  
Echocardiographic Images ◽  
The Right ◽  
Descriptive Method ◽  
Membranous Septum

AbstractMany of the controversies surrounding the description of ventricular septal defects arise from differences in the perspectives from which they are viewed. In this review, we analyse these defects as seen in cross-sectional echocardiographic images, correlating them with morphologic specimens. The classification we advocate, which now has a suitable pedigree, is a simple descriptive method distinguishing between perimembranous, muscular, and doubly committed types of defects. The approach is to categorise the defects as seen from the right ventricle, the usual port of access for surgeons. The term ‘perimembranous’ highlights the proximity of the atrioventricular conduction axis to the margin of the defects in which the remnant of the membranous septum forms a direct border. This system is applicable to all interventricular communications, no matter how malformed the heart may be in which they are enclosed.

Holes and channels between the ventricles revisited

2014 ◽  
Vol 25 (6) ◽  
pp. 1099-1110 ◽  
Author(s):  
Adrian Crucean ◽  
William J. Brawn ◽  
Diane E. Spicer ◽  
Rodney C. Franklin ◽  
Robert H. Anderson
Keyword(s):  
Right Ventricle ◽  
Aortic Coarctation ◽  
Full Description ◽  
Ventricular Septal Defects ◽  
Children's Hospital ◽  
Septal Defects ◽  
Children’S Hospital ◽  
The Right ◽  
Phenotypic Specificity ◽  
Combining Information

AbstractBackgroundAlthough holes, or channels, between the ventricles are the commonest congenital cardiac malformations, there is still no consensus as to how they can best be described and categorised. So as to assess whether it is possible to produce a potentially universally acceptable system, we have analysed the hearts categorised as having ventricular septal defects in a large archive held at Birmingham Children’s Hospital.Materials and methodsWe analysed all the hearts categorised as having isolated ventricular septal defects, or those associated with aortic coarctation or interruption in the setting of concordant ventriculo-arterial connections, in the archive of autopsied hearts held at Birmingham Children’s Hospital, United Kingdom.ResultsWe found 147 hearts within the archive fulfilling our criterions for inclusion. All could be classified within one of three groups depending on their borders as seen from the right ventricle. To provide full description, however, it was also necessary to take account of the way the defects opened to the right ventricle, and the presence or absence of alignment between the septal components.ConclusionsBy combining information on the phenotypic specificity defined on the basis of their borders, the direction of opening into the right ventricle, and the presence or absence of septal malalignment, it proved possible to categorise all hearts examined within the archive of Birmingham Children’s Hospital. Our findings have necessitated creation of new numbers within the European Paediatric Cardiac Code.

Initial clinical manifestations and mid- and long-term results after surgical repair of double-chambered right ventricle in children and adults

2008 ◽  
Vol 18 (3) ◽  
pp. 268-274 ◽  
Author(s):  
Ragiab Telagh ◽  
Vladimir Alexi-Meskishvili ◽  
Ronald Hetzer ◽  
Peter E. Lange ◽  
Felix Berger ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Septal Defect ◽  
Surgical Repair ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
The Right

AbstractObjectiveBy means of retrospective analysis of our institutional experience, we reviewed the clinical manifestation and outcomes of patients subsequent to surgical repair of double-chambered right ventricle.MethodsBetween 1988 and 2005, we performed surgical repair in 35 of 37 patients diagnosed with double-chambered right ventricle. The patients ranged in age from 4 to 69 years, with a mean of 21.3 years. Most presented in infancy, with initial manifestation of a short systolic murmur in 34 (92%) of all cases. Pressure gradients were measured invasively across the right ventricular outflow tract of between 30 and 140 mmHg, with a median of 60 mmHg. An associated ventricular septal defect was present in 26 patients (70%). Of the group, 4 patients were aged over 40 years, and 2 had previously undergone operative closure of a ventricular septal defect.ResultsThe operative interval ranged from 2 months to 41 years, with a median of 9 years. In all, we resected muscular bundles and enlarged the right ventricular outflow tract. There was no hospital or late death. Median follow-up subsequent to surgery was 7 years, with a range from 0.4 to 11 years. No patient required further surgery to relieve any obstruction of the right ventricular outflow tract, nor long term medical therapy or pacing because of cardiac arrhythmia.ConclusionsSurgical repair of a double-chambered right ventricle yields excellent haemodynamic and functional results over the mid to long term.

scholarly journals Late Follow-Up of Persistent Truncus Arteriosus, after one-Stage Repair, With Right Ventricular Remodeling

2020 ◽  
pp. 1-3
Author(s):  
Miguel Maluf ◽  
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Remodeling ◽  
Surgical Repair ◽  
Pulmonary Valve ◽  
Truncus Arteriosus ◽  
Persistent Truncus Arteriosus ◽  
The Right ◽  
Right Ventricular Remodeling

We report long-term outcome after one-stage, surgical repair, in a two months- old girl with Persistent Truncus Arteriosus type I, II. The operation was carried out with the remodeling of the right ventricle, using a swine bicuspid pulmonary prosthesis. Twenty-six years later, the patient is in excellent clinical condition, CF I (NYHA), with normal peripheral oxygen saturation. Recent invasive and not invasive imaging show: absence of intracardiac shunt and growing of the right ventricle outlet tract and discrete double lesion of the pulmonary valve. The pulmonary flow directed uniformly for both lungs. In selected cases, the long- term prognosis of patients with truncus arteriosus, undergoing early surgical repair, avoiding the use of valved conduit, makes for an excellent evolution, without new interventions. Endovascular procedures, now well standardized, for the implantation of a pulmonary valve stent, through a catheter, will allow an effective approach, in the presence of late obstructions, in patients who have undergone right ventricular remodeling, without the use of valved conduits.

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