Comparison of Continuous and Interrupted Suturing Techniques in Ventricular Septal Defect Closure
Background: Our goal is to evaluate postoperative outcomes of continuous versus interrupted suturing techniques in ventricular septal defect (VSD) closure surgery.
Methods: The study included 286 patients with isolated VSD who underwent VSD closure surgery between June 2010 and April 2017. VSD closure was performed by using the interrupted suturing technique in group 1 (n = 74, 25.9%) and the continuous suturing technique in group 2 (n = 212, 74.1%). The groups were compared in terms of mortality and rates of clinical morbidities such as infection and complete atrioventricular (AV) block.
Results: Early mortality occurred in 3 cases in group 1 (4.0%) and 5 cases in group 2 (2.3%). There was no late mortality in either group. One patient from both groups required extracorporeal membrane oxygenation (ECMO) at postoperative 48 hours. Five patients in group 1 (6.8%) and 11 patients in group 2 (5.2%) developed complete AV block postoperatively and received permanent pacemaker implants.
Conclusion: Complication rates were similar between the patient groups operated on by using continuous and interrupted suturing techniques in our study, suggesting that neither technique is superior for VSD closure surgery.
Anderson BR, Stevens KN, Nicolson SC, et al. 2013. Contemporary outcomes of surgical ventricular septal defect closure. J Thorac Cardiovasc Surg 145:641-7.
Atik FA, Afiune JY, Caneo LF. 2009. Autologous pericardium patch aneurysm after ventricular septal defect closure and arterial switch operation. J Card Surg 24:479-80.
Bahtiyar MO, Dulay AT, Weeks BP, Friedman AH, Copel JA. 2008. Prenatal course of isolated muscular ventricular septal defects diagnosed only by color Doppler sonography: single-institution experience. J Ultrasound Med 27:715-20.
Bol Raap G, Meijboom FJ, Kappetein AP, Galema TW, Yap SC, Bogers AJ. 2007. Long-term follow-up and quality of life after closure of ventricular septal defect in adults. Eur J Cardiothorac Surg 32:215-9.
Caimmi PP, Grossini E, Kapetanakis EI, et al. 2010. Double patch repair through a single ventriculotomy for ischemic ventricular septal defects. Ann Thorac Surg 89:1679-81.
Erdil N, Birincioğlu CL, İşcan HZ, et al. 2000. İzole ventriküler septal defekt cerrahi tedavisinde erken ve geç dönem sonuçlar. [Early and late term results in surgical treatment of isolated ventricular septal defects]. T Klin J Cardiol 13:83-90. Turkish.
Gaynor JW, O’Brien JE Jr, Rychik J, Sanchez GR, DeCampli WM, Spray TL. 2001. Outcome following tricuspid valve detachment for ventricular septal defect closure. Eur J Cardiothorac Surg 19:279-82.
Grabitz RG, Joffers MR, Collins-Nakai RL. 1988. Congenital heart disease: incidence in the first year of life. The Alberta heritage pediatric cardiology program. Am J Epidemiol 128:381-8.
Hoffman JI, Kaplan S, Liberthson RR. 2004. Prevalence of congenital heart disease. Am Heart J 147:425-39.
Mercan AŞ, Saygılı A, Sezgin A, et al. 2001. İnfant ventriküler septal defekt cerrahisinde risk faktörleri. [Risk factors in infant ventricular septal defect surgery]. Turkish J Thorac Cardiovasc Surg 9:149-52. Turkish
Pridjian AK, Pearce FB, Culpepper WS, Williams LC, Van Meter CH, Ochsner JL. 1993. Atrioventricular valve competence after take-down to improve exposure during ventricular septal defect repair. J Thorac Cardiovasc Surg 106:1122-5.
Sim EK, Grignani RT, Wong ML, et al. 1999. Outcome of surgical closure of doubly committed subarterial ventricular septal defect. Ann Thorac Surg 67:736-8.
Stirling GR, Stanley PH, Lillehei CW. 1957. The effects of cardiac bypass and ventriculotomy upon right ventricular function; with report of successful closure of ventricular septal defect by use of atriotomy. Surg Forum 8:433-8.
Tatebe S, Miyamura H, Watanabe H, Suqawara M, Equchi S. 1995. Closure of isolated ventricular septal defect with detachment of the tricuspid valve. J Card Surg 10:564-8.
Tucker EM, Pyles LA, Bass JL, Moller JH. 2007. Permanent pacemaker for atrioventricular conduction block after operative repair of perimembranous ventricular septal defect. J Am Coll Cardiol 50:1196-200.
Tynan M, Anderson RH. Ventricular septal defect. In: Anderson RH, Baker EJ, Macartney FJ, Rigby ML, Shinebourne EA, Tynan M, editors. Paediatric cardiology. Edinburgh: Churchill Livingstone; 2002. p. 983-1014.
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