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Trans-atrial approach to the "Swiss-cheese" ventricular septal defects: Sandwich technique

  • Naoki Yoshimura
    Correspondence
    Corresponding author: Naoki Yoshimura, Department of Cardiovascular Surgery, University of Toyama, Graduate School of Medicine, 2630 Sugitani, Toyama 930-0194, Toyama, Japan
    Affiliations
    Department of Cardiovascular Surgery, University of Toyama, Graduate School of Medicine, 2630 Sugitani, Toyama 930-0194, Toyama, Japan
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  • Hironori Matsuhisa
    Affiliations
    Department of Cardiovascular Surgery, Kobe Children's Hospital, 1-6-7 Minatojimaminami-cho, Chuo-ku, Kobe 650-0047, Hyogo, Japan, +81-78-945-7300
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  • Yoshihiro Oshima
    Affiliations
    Department of Cardiovascular Surgery, Kobe Children's Hospital, 1-6-7 Minatojimaminami-cho, Chuo-ku, Kobe 650-0047, Hyogo, Japan, +81-78-945-7300
    Search for articles by this author

      Abstract

      The closure of Swiss-cheese multiple ventricular septal defects remains a difficult technical challenge and it is associated with increased mortality. Recently, the felt sandwich technique has been widely used to close muscular ventricular septal defects because the technique is simple, safe, effective, and reproducible. This technique may be useful, especially in complex cases, because it does not require prolonged surgical time. However, the use of numerous felt patches may disturb the movement of interventricular septum and cause cardiac dysfunction in infants. To avoid postoperative cardiac dysfunction, our current strategy is implemented to close muscular ventricular septal defects directly as much as possible. When the ventricular septal defect is considered unsuitable for direct closure, the felt sandwich technique is a useful tool that can be applied as needed by surgeons.

      Keywords

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