Department of Cardiac Surgery and Transplantation, S. Camillo Hospital, Rome, Italy.
Department of Cardiac Surgery and Transplantation, S. Camillo Hospital, Rome, Italy.
Ann Thorac Surg. 2019 Feb;107(2):e147-e149. doi: 10.1016/j.athoracsur.2018.08.077. Epub 2018 Oct 22.
Ventricular septal defect (VSD) is a life-threatening complication of myocardial infarction. Surgical repair is generally performed through a left/right ventriculotomy. To avoid complications associated with ventriculotomy, a right transatrial approach has been proposed. We describe a modified transatrial approach through the left atrium for basal-inferior VSD. After left atriotomy, mitral valve is detached from the annulus to expose the defect, which is closed with a pericardial patch. Two patients were operated by this method. In both cases venoarterial extracorporeal membrane oxygenation with a ventricular vent was utilized to unload the left ventricle. Echocardiography revealed no residual shunt in both cases.
室间隔缺损 (VSD) 是心肌梗死的一种危及生命的并发症。外科修复通常通过左/右心室切开术进行。为避免与心室切开术相关的并发症，已提出右心房经心房入路。我们描述了一种通过左心房的改良经心房入路用于基底下 VSD。左心房切开后，二尖瓣从瓣环上分离以暴露缺陷，并用心包补片关闭。两名患者采用该方法进行了手术。在两种情况下，均使用带心室引流管的静脉动脉体外膜肺氧合来减轻左心室的负荷。超声心动图显示两种情况下均无残余分流。
