Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지
DOI QR코드

DOI QR Code

Surgery for a Muscular Type Ventricular Septal Defect via Right Apical Ventriculotomy - A case report -

우심첨부 절개술을 통한 심첨부 근육형 심실중격결손증 수술 - 1예 보고 -

  • Lee, Chung Eun (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine, Hospital and Institute of Health Sciences) ;
  • Rhie, Sang-Ho (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine, Hospital and Institute of Health Sciences) ;
  • Mun, Sung-Ho (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine, Hospital and Institute of Health Sciences) ;
  • Choi, Jun-Young (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine, Hospital and Institute of Health Sciences) ;
  • Jang, In-Seok (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine, Hospital and Institute of Health Sciences) ;
  • Kim, Jong-Woo (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine, Hospital and Institute of Health Sciences)
  • 이정은 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교병원, 경상대학교 건강과학연구원) ;
  • 이상호 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교병원, 경상대학교 건강과학연구원) ;
  • 문성호 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교병원, 경상대학교 건강과학연구원) ;
  • 최준영 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교병원, 경상대학교 건강과학연구원) ;
  • 장인석 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교병원, 경상대학교 건강과학연구원) ;
  • 김종우 (경상대학교 의학전문대학원 흉부외과학교실, 경상대학교병원, 경상대학교 건강과학연구원)
  • Received : 2009.08.28
  • Accepted : 2009.10.20
  • Published : 2010.02.05
⟨ Previous Next ⟩

Abstract

Apical muscular ventricular septal defects (VSDs) are relatively rare conditions among all the different types of VSDs. Apical VSDs are difficult to treat because of they are difficult to visualize through a trans-atrioventricular approach, and especially in infants. Treatment by left ventriculotomy is associated with long-term ventricular dysfunction. Catheter-based intervention still shows less than satisfactory results and this type of intervention may not be possible in small infants. This report describes the benefits of right apical ventriculotomy in terms of successful closure of the lesion without harming the ventricular function.

심실중격결손증 중 심첨부 근육형은 드문 심기형이다. 특히 소아에서는 시야확보가 어려워 심방실을 통한 접근은 치료가 힘들다. 좌심실을 통한 치료는 장기적으로 좌심실 기능부전을 가져온다. 혈관 중재술을 통한 치료는 아직 만족스런 결과를 얻기 힘들며 어린 소아에서는 가능하지도 않다. 심첨부 근육형 심실중격결손증의 수술 시 우심첨부 절개술이 시야확보가 용이하며 심실기능에 손상을 주지 않고 안전하고 성공적인 교정술이 가능하였음을 보고한다.

Keywords

References

  1. Mavroudis C, Baker CL, Jacobs JP. Ventricular septal defect. In: Mavroudis C. Pediatric cardiac surgery. 3rd ed. Philadelphia: Mosby. 2003;298-320
  2. Lee SK, Kim SC, Kwon OC, et al. Clinical analysis of ventricular septal defect. Korean J Thorac Cardiovasc Surg 1986;19:265-72
  3. Holzer R, Balzer D, Cao QL, et al. Device closure of muscular VSDs using the Amplatzer muscular ventricular septal defect occluder: immediate and mid-term results of a U.S. registry. J Am Coll Cardiol 2004;43:1257-63 https://doi.org/10.1016/j.jacc.2003.10.047
  4. Okubo M, Benzon LN, Nykanen D, et al. Outcomes of intraoperative device closure of muscular ventricular septal defects. Ann Thorac Surg 2001;72:416-23 https://doi.org/10.1016/S0003-4975(01)02829-6
  5. Myhre U, Duncan BW, Mee RBB, et al. Apical right ventriculotomy for closure of apical ventricular septal defects. Ann Thorac Surg 2004;78:204-8 https://doi.org/10.1016/j.athoracsur.2003.12.054
  6. Tsang VT, Hsia TY, Robert WM, et al. Surgical repair of supposedly multiple defects within the apical part of the muscular ventricular septum. Ann Thorac Surg 2002;73:58-63 https://doi.org/10.1016/S0003-4975(01)03171-X
  7. Van Praagh S, Mayer JE Jr, Berman NB, et al. Apical ventricular septal defects: follow-up concerning anatomic and surgical considerations. Ann Thorac Surg 2002;73:48-56 https://doi.org/10.1016/S0003-4975(01)03249-0
  8. Stellin G, Padalino M, Milanesi O, et al. Surgical closure of apical ventricular septal defects through a right ventricular apical infundibulotomy. Ann Thorac Surg 2000;69:597-601 https://doi.org/10.1016/S0003-4975(99)01333-8