Kitamura S, Oyama C, Kawachi K, Miyagi Y, Morita R, Yamada Y, Taniguchi S
Ann Thorac Surg. 1984 Dec;38(6):640-3. doi: 10.1016/s0003-4975(10)62327-2.
A new method of closing a perimembranous malalignment ventricular septal defect (VSD) in corrected transposition of the great arteries (TGA) of the [S,L,L] type is presented. The method consists of combined approaches to the VSD through both a right atriotomy and an aortotomy without a ventriculotomy. The VSD is patched obliquely from the morphological right ventricular side of the septum, cranially through the aortic valve to the left ventricular side of the septum, caudally through the mitral valve. Although this method has been successfully applied in only one adult patient, some advantages may be expected: (1) prevention of trauma to the His bundle, which runs along the anterosuperior rim of the VSD on the left ventricular side; and (2) prevention of trauma to the tricuspid, mitral, and aortic valves without having to open the ventricles. We believe that this new method warrants a further trial as possibly better for closure of the VSD in corrected TGA of the [S,L,L] type.
本文介绍了一种闭合[S,L,L]型矫正型大动脉转位（TGA）中膜周部对位不良型室间隔缺损（VSD）的新方法。该方法包括通过右心房切开术和主动脉切开术联合处理VSD，而无需进行心室切开术。室间隔缺损从形态学右心室侧斜向修补，向上穿过主动脉瓣至室间隔左心室侧，向下穿过二尖瓣。尽管该方法仅成功应用于1例成年患者，但仍可预期具有一些优点：（1）避免损伤沿室间隔缺损左心室侧前上缘走行的希氏束；（2）避免打开心室，从而防止损伤三尖瓣、二尖瓣和主动脉瓣。我们认为，这种新方法值得进一步试验，因为它可能更有利于闭合[S,L,L]型矫正型TGA中的室间隔缺损。
