Delayed Closure of Multiple Muscular Ventricular Septal Defects in an Infant after Coarctation Repair and a Hybrid Procedure—A Case Report

Authors

  • Ireneusz Haponiuk
  • Maciej Chojnicki
  • Rados?aw Jaworski
  • Jacek Ju?ci?ski
  • Mariusz Steffek
  • Lucyna Pa?kowska

DOI:

https://doi.org/10.1532/HSF98.20101081

Abstract

There are several strategies of surgical approach for the repair of multiple muscular ventricular septal defects (mVSDs), but none leads to a fully predictable, satisfactory therapeutic outcome in infants. We followed a concept of treating multiple mVSDs consisting of a hybrid approach based on intraoperative perventricular implantation of occluding devices. In this report, we describe a 2-step procedure consisting of a final hybrid approach for multiple mVSDs in the infant following initial coarctation repair with pulmonary artery banding in the newborn. At 7 months, sternotomy and debanding were performed, the right ventricle was punctured under transesophageal echocardiographic guidance, and the 8-mm device was implanted into the septal defect. Color Doppler echocardiography results showed complete closure of all VSDs by 11 months after surgery, probably via a mechanism of a localized inflammatory response reaction, ventricular septum growth, and implant endothelization.

References

Crossland DS, Wilkinson JL, Cochrane AD, d'Udekem Y, Brizard CP, Lane GK. 2008. Initial results of primary device closure of large muscular ventricular septal defects in early infancy using perventricular access. Catheter Cardiovasc Interv 72:386-91.nHolzer R, Balzer D, Cao QL, Lock K, Hijazi ZM, Amplatzer Muscular Ventricular Septal Defect Investigators. 2004. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder: immediate and mid-term results of a U. S. Registry. J Am Coll Cardiol 43:1257-63.nSpevak PJ, Mandell VS, Colan SD, et al. 1993. Reliability of Doppler color flow mapping in the identification and localization of multiple ventricular septal defects. Echocardiography 10:573-81.nWollenek G, Wyse R, Sullivan I, Elliott M, de Leval M, Stark J. 1996. Closure of muscular ventricular septal defects through a left ventriculotomy. Eur J Cardiothorac Surg 10:595-8.n

Published

2011-02-23

How to Cite

Haponiuk, I., Chojnicki, M., Jaworski, R., Ju?ci?ski, J., Steffek, M., & Pa?kowska, L. (2011). Delayed Closure of Multiple Muscular Ventricular Septal Defects in an Infant after Coarctation Repair and a Hybrid Procedure—A Case Report. The Heart Surgery Forum, 14(1), E67-E69. https://doi.org/10.1532/HSF98.20101081

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