Clinical Study for Surgical Treatment of Congenital Heart Diseases

선천성 심혈관 질환의 수술요법에 관한 임상적 고찰

From July 1984 to September 1990, 316 patients of congenital heart diseases were operated and 15 patients died. Hospital mortality was 4.75%. Five patients of 73 PDA had residual shunt after operation: 4 were ligated under support of Dacron patch, 1 was closed through the pulmonary arteriotomy under CPB. 3 patients were reoperated. No patient had residual shunt or reopening among the patients of simple ligation or division and suture. During the ligation of PDA, Dacron patch for protection from tearing may disturb the complete interruption of shunt. If the tissue around the ductus arteriosus looks weak or fragile, division and suture may be more reliable other than ligation with supporting patch. If the septal leaflet of tricuspid valve is adherent around the VSD, remained opening of VSD may be closed with simple suture directly. In these cases, the incidence of postoperative residual shunt is as high as the incidence of more large VSD closed with patch [10.9%: 9.6%]. During the direct closure of remained opening of VSD, another leaking route should be looked for carefully beneath the septal leaflet of tricuspid valve.