Abstract | OBJECTIVE: METHODS: A median sternotomy or a subxiphoid minimally invasive incision was performed. Under continuous transesophageal echocardiographic guidance, the right ventricle free wall was punctured, and a wire was introduced across the largest defect. The Amplatzer (AGA Medical Corporation, Golden Valley, Minn) muscular ventricular septal defect occluding device (a self-expandable double-disk device) was used. An introducer sheath was fed over the wire, with the sheath tip positioned in the left ventricle cavity. The device was then advanced inside the sheath and deployed by retracting the sheath. Associated cardiac lesions, if any, can then be repaired during cardiopulmonary bypass. A similar technique can also be applied for periatrial closure of complex atrial septal defects. RESULTS: The initial 6 patients are presented. Cardiopulmonary bypass was not needed in any patient for placement of the device and needed in 4 patients for repair of concomitant malformations only ( double-outlet right ventricle, aortic arch hypoplasia, pulmonary artery band removal). No complications from using this technique occurred. Discharge echocardiograms showed no significant shunting across the ventricular septum. CONCLUSIONS:
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Authors | Emile A Bacha, Qi-Ling Cao, Joanne P Starr, David Waight, Makram R Ebeid, Ziyad M Hijazi |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 126
Issue 6
Pg. 1718-23
(Dec 2003)
ISSN: 0022-5223 [Print] United States |
PMID | 14688678
(Publication Type: Journal Article)
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Topics |
- Cardiac Surgical Procedures
(instrumentation, methods)
- Child, Preschool
- Echocardiography, Transesophageal
- Heart Septal Defects, Ventricular
(diagnostic imaging, surgery)
- Humans
- Infant
- Infant, Newborn
- Minimally Invasive Surgical Procedures
(methods)
- Prostheses and Implants
- Ultrasonography, Interventional
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