Ventricular septal defect surgical repair

WikiDoc Resources for Ventricular septal defect surgical repair
Articles
Most recent articles on Ventricular septal defect surgical repair Most cited articles on Ventricular septal defect surgical repair Review articles on Ventricular septal defect surgical repair Articles on Ventricular septal defect surgical repair in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Ventricular septal defect surgical repair Images of Ventricular septal defect surgical repair Photos of Ventricular septal defect surgical repair Podcasts & MP3s on Ventricular septal defect surgical repair Videos on Ventricular septal defect surgical repair
Evidence Based Medicine
Cochrane Collaboration on Ventricular septal defect surgical repair Bandolier on Ventricular septal defect surgical repair TRIP on Ventricular septal defect surgical repair
Clinical Trials
Ongoing Trials on Ventricular septal defect surgical repair at Clinical Trials.gov Trial results on Ventricular septal defect surgical repair Clinical Trials on Ventricular septal defect surgical repair at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Ventricular septal defect surgical repair NICE Guidance on Ventricular septal defect surgical repair NHS PRODIGY Guidance FDA on Ventricular septal defect surgical repair CDC on Ventricular septal defect surgical repair
Books
Books on Ventricular septal defect surgical repair
News
Ventricular septal defect surgical repair in the news Be alerted to news on Ventricular septal defect surgical repair News trends on Ventricular septal defect surgical repair
Commentary
Blogs on Ventricular septal defect surgical repair
Definitions
Definitions of Ventricular septal defect surgical repair
Patient Resources / Community
Patient resources on Ventricular septal defect surgical repair Discussion groups on Ventricular septal defect surgical repair Patient Handouts on Ventricular septal defect surgical repair Directions to Hospitals Treating Ventricular septal defect surgical repair Risk calculators and risk factors for Ventricular septal defect surgical repair
Healthcare Provider Resources
Symptoms of Ventricular septal defect surgical repair Causes & Risk Factors for Ventricular septal defect surgical repair Diagnostic studies for Ventricular septal defect surgical repair Treatment of Ventricular septal defect surgical repair
Continuing Medical Education (CME)
CME Programs on Ventricular septal defect surgical repair
International
Ventricular septal defect surgical repair en Espanol Ventricular septal defect surgical repair en Francais
Business
Ventricular septal defect surgical repair in the Marketplace Patents on Ventricular septal defect surgical repair
Experimental / Informatics
List of terms related to Ventricular septal defect surgical repair

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] and Leida Perez, M.D.

Associate Editor-in-Chief: Keri Shafer, M.D. [2]

Surgical technique for Repair of Perimembranous VSD

a) Perimembranous VSD is repaired on cardiopulmonary bypass with ischemic arrest. Device closure is rarely used in the United States because of the reported incidence of early and late onset complete heart block after device closure, presumably secondary to device trauma to the AV node.

b) Surgical exposure is achieved through the right atrium. The tricuspid valve septal leaflet is retracted or incised to expose the defect margins.

c) Several patch materials are available, including native pericardium, bovine pericardium, PTFE (Goretex(tm) or Impra(tm), or dacron.

d) Suture techniques include horizontal pledgeted mattress sutures, and running polypropylene suture.

e) Critical attention is necessary to avoid injury to the conduction system located on the left ventricular side of the interventricular septum near the papillary muscle of the conus.

f) Care is taken to avoid injury to the aortic valve with sutures.

g) The heart is extensively deaired by venting blood through the aortic cardioplegia site, and by infusing Carbon Dioxide into the operative field to displace air.

h) Intraoperative transesophageal echocardiography is used to confirm secure closure of the VSD, function of the aortic valve, ventricular function, and the elimination of all air from the left side of the heart.

i) The sternum is closed, with potential placement of a local anesthetic infusion catheter under the fascia, to stabilize postoperative pain control.

j) A video of Perimembranous VSD repair, including the operative technique, and the daily postoperative recovery, can be seen here: VSD Repair, Perimembranous Ventricular Septal Defect Repair Video