Comparison of the Operative Approaches for Repair of Ventricular Septal Defect

심실중격결손의 개심교정에 있어서 수술 접근방법에 따른 차이

We compared postoperative results according to the different surgical approach in 180 cases of isolated ventricular septal defects operated at the department of Thoracic and Cardiovascular Surgery in Kyungpook University Hospital from January 1987 to December 1991. Of the 180 cases, 109 were males and 71 females, age ranging from 6 months to 15 years (mean: 5.6 years) and body weight ranging from 6 to 52㎏(mean : 20㎏). According to Soto's classification, perimembranous types were comprised of 119 cases (66％), doubly committed subarterial type 49 cases(27％), and muscular type 12 cases(7％). Patients were divided into three groups according to the incision methods: right atriotomy group (39％), right ventriculotomy group (47％), and pulmonary arteriotomy group (14％). The mean aortic cross clamp time was shorter in right atriotomy group (39 min.) than right ventriculotomy group (79min.) in the cases of large perimembranous VSD (P＜0.001). Spontanous recovery rate of cardiac rhythm after VSD closure was higher in right atriotomy group (51％) than right ventriculotomy group (32％) in the cases of perimembranous VSD (P＜0.05). The incidence of postoperative RBBB was 17.6％ with no statistical differences between right atriotomy group(17.9％) and right ventriculotomy group(19.2％). Overall mortality rate was 5.6％(10 cases) with no significant differences according to surgical approach.