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“Swiss cheese” septal defects: surgical closure using a single patch with intermediate fixings

1999; Elsevier BV; Volume: 67; Issue: 6 Linguagem: Inglês

10.1016/s0003-4975(99)00325-2

1552-6259

Loı̈c Macé, Patrice Dervanian, Emmanuel Le Bret, Thierry Folliguet, Virginie Lambert, J Losay, Jean-Yves Neveux,

Infective Endocarditis Diagnosis and Management

Residual ventricular septal defects and ventricular and septal dysfunctions are surgical drawbacks of "Swiss cheese" defects. We developed a technique that uses a single patch with intermediate fixings to cover the right side of the septum without producing a septal bulging, through a right atriotomy.Since April 1993, 5 children with "Swiss cheese" defects have been operated on using this procedure (mean age, 17 +/- 12 months). Three patients had associated lesions including tetralogy of Fallot, Taussig Bing heart, and mitral stenosis.There have been no early or late deaths. The mean follow-up time is 29 +/- 18 months. All patients are asymptomatic. Echocardiography revealed either an intact septum (n = 4) or insignificant color jets at the apical portion of the septum (n = 1). The septal wall motion was preserved in 4 children and was hypokinetic in the fifth child.This technique can be an additional tool to provide a secure closure of "Swiss cheese" defects even in the presence of associated cardiac lesions. Long-term consequences of this procedure on septal wall motion remain to be determined.