Surgical management of trabecular ventricular septal defects: The sandwich technique Yoshio Ootaki, MD, Masahiro Yamaguchi, MD, Naoki Yoshimura, MD, Shigeteru.

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Presentation transcript:

Surgical management of trabecular ventricular septal defects: The sandwich technique Yoshio Ootaki, MD, Masahiro Yamaguchi, MD, Naoki Yoshimura, MD, Shigeteru Oka, MD, Masahiro Yoshida, MD, Tomomi Hasegawa, MD The Journal of Thoracic and Cardiovascular Surgery Volume 125, Issue 3, Pages 508-512 (March 2003) DOI: 10.1067/mtc.2003.56 Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Location of VSDs. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 508-512DOI: (10.1067/mtc.2003.56) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 A, Negotiating 2 forceps through the tricuspid valve and mitral valve permits the opening of the trabecular VSD. B and C, Two forceps lead the Nelaton catheter through the trabecular VSD. D, The Nelaton catheter leads an oversized (at least 8-10 mm larger than the estimated size of the VSD) circular polyester felt patch mounted on a 3-0 Nespolen suture into the left ventricle through the mitral valve. E, The right-sided patch was sewn to the 3-0 Nesporen suture. F, The Nespolen suture is then tied firmly, thereby sandwiching the septum between the 2 polyester felt patches. LV, Left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium; TV, tricuspid valve; MV, mitral valve. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 508-512DOI: (10.1067/mtc.2003.56) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Left ventriculography of patient 3. A, Preoperative left ventriculography showed perimembranous and trabecular VSDs. B, Left ventriculography 1 month postoperatively showed a minimal residual shunt. C, Left ventriculography 14 months postoperatively did not show any residual shunt. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 508-512DOI: (10.1067/mtc.2003.56) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions