Advertisement

Hybrid Closure of Muscular Ventricular Septal Defects: Anatomy, Clinical Scenarios, and Techniques

  • Kiran K. Mallula
  • Zahid AminEmail author
Chapter

Abstract

Congenital ventricular septal defects (VSDs) can exist as isolated defects or may be associated with other cardiac anomalies, such as tetralogy of Fallot, double outlet right ventricle (DORV), D-transposition of great arteries (D-TGA), truncus arteriosus, or interrupted aortic arch. To date, there is no consensus on the best way to classify such defects, nor even on the curved surface that is taken to represent the defect [1]. Muscular VSDs (mVSDs) are the second most common type of VSD after perimembranous defects based on most series and account for 10–15 % of all VSDs [2, 3]. These have exclusively muscular borders and can have gross malalignment between their caudal and cranial borders. In addition to this malalignment, they can open into different parts of the right ventricle. They can be further subclassified based on their geographical location whether they open centrally, apically, anteriorly, or to the right ventricular inlet or outlet components [1]. The left ventricular view shows fewer overlying trabeculae, and multiple defects frequently coalesce to form a single defect on the left side. Occasionally such apical defects are quite large [4, 5].

Keywords

Ventricular Free Wall Double Outlet Right Ventricle Interrupted Aortic Arch Delivery Sheath Mitral Valve Apparatus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Spicer DE, Hsu HH, Co-Vu J, Anderson RH, Fricker FJ. Ventricular septal defect. Orphanet J Rare Dis. 2014;9:144.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Soto B, Becker AE, Moulaert AJ, Lie JT, Anderson RH. Classification of ventricular septal defects. Br Heart J. 1980;43(3):332–43.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Becker AE, Anderson RH. Classification of ventricular septal defects – a matter of precision. Heart Vessels. 1985;1(2):120–1.CrossRefPubMedGoogle Scholar
  4. 4.
    Wenink AC, Oppenheimer-Dekker A, Moulaert AJ. Muscular ventricular septal defects: a reappraisal of the anatomy. Am J Cardiol. 1979;43(2):259–64.CrossRefPubMedGoogle Scholar
  5. 5.
    Anderson RH, Wilcox BR. The surgical anatomy of ventricular septal defect. J Card Surg. 1992;7(1):17–35.CrossRefPubMedGoogle Scholar
  6. 6.
    Love BA, Whang B, Filsoufi F. Perventricular device closure of post-myocardial infarction ventricular septal defect on the beating heart. J Thorac Cardiovasc Surg. 2011;142(1):230–2.CrossRefPubMedGoogle Scholar
  7. 7.
    Kirklin JK, Castaneda AR, Keane JF, Fellows KE, Norwood WI. Surgical management of multiple ventricular septal defects. J Thorac Cardiovasc Surg. 1980;80(4):485–93.PubMedGoogle Scholar
  8. 8.
    Kitagawa T, Durham 3rd LA, Mosca RS, Bove EL. Techniques and results in the management of multiple ventricular septal defects. J Thorac Cardiovasc Surg. 1998;115(4):848–56.CrossRefPubMedGoogle Scholar
  9. 9.
    Wollenek G, Wyse R, Sullivan I, Elliott M, de Leval M, Stark J. Closure of muscular ventricular septal defects through a left ventriculotomy. Eur J Cardiothorac Surg. 1996;10(8):595–8.CrossRefPubMedGoogle Scholar
  10. 10.
    McDaniel N, Gutgesell HP, Nolan SP, Kron IL. Repair of large muscular ventricular septal defects in infants employing left ventriculotomy. Ann Thorac Surg. 1989;47(4):593–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Holzer R, Balzer D, Cao QL, Lock K, Hijazi ZM. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder: immediate and mid-term results of a U.S. registry. J Am Coll Cardiol. 2004;43(7):1257–63.CrossRefPubMedGoogle Scholar
  12. 12.
    Amin Z, Berry JM, Foker JE, Rocchini AP, Bass JL. Intraoperative closure of muscular ventricular septal defect in a canine model and application of the technique in a baby. J Thorac Cardiovasc Surg. 1998;115(6):1374–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Amin Z, Gu X, Berry JM, Titus JL, Gidding SS, Rocchini AP. Perventricular [correction of Periventricular] closure of ventricular septal defects without cardiopulmonary bypass. Ann Thorac Surg. 1999;68(1):149–53. discussion 153–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Kang SL, Tometzki A, Caputo M, Morgan G, Parry A, Martin R. Longer-term outcome of perventricular device closure of muscular ventricular septal defects in children. Catheter Cardiovasc Interv. 2015;85(6):998–1005.CrossRefPubMedGoogle Scholar
  15. 15.
    Pedra CA, Pedra SR, Chaccur P, Jatene M, Costa RN, Hijazi ZM, Amin Z. Perventricular device closure of congenital muscular ventricular septal defects. Expert Rev Cardiovasc Ther. 2010;8(5):663–74.CrossRefPubMedGoogle Scholar
  16. 16.
    Haponiuk I, Chojnicki M, Jaworski R, Steffek M, Juscinski J, Sroka M, Fiszer R, Sendrowska A, Gierat-Haponiuk K, Maruszewski B. Hybrid approach for closure of muscular ventricular septal defects. Med Sci Monit. 2013;19:618–24.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Diab KA, Cao QL, Hijazi ZM. Perventricular closure of muscular ventricular septal defects: how do I do it? Ann Pediatr Cardiol. 2008;1(1):27–33.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Elhmidi Y, Hoerer J, Lange R, Schreiber C. Muscular ventricular septal defect in a newborn with truncus arteriosus communis: perventricular transcatheter closure under echocardiographic guidance only, a case report. World J Pediatr Congenit Heart Surg. 2014;5(4):589–91.CrossRefPubMedGoogle Scholar
  19. 19.
    Chaturvedi RR, Shore DF, Yacoub M, Redington AN. Intraoperative apical ventricular septal defect closure using a modified Rashkind double umbrella. Heart. 1996;76(4):367–9.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Okubo M, Benson LN, Nykanen D, Azakie A, Van Arsdell G, Coles J, Williams WG. Outcomes of intraoperative device closure of muscular ventricular septal defects. Ann Thorac Surg. 2001;72(2):416–23.CrossRefPubMedGoogle Scholar
  21. 21.
    Amin Z, Cao QL, Hijazi ZM. Closure of muscular ventricular septal defects: transcatheter and hybrid techniques. Catheter Cardiovasc Interv. 2008;72(1):102–11.PubMedGoogle Scholar
  22. 22.
    Neukamm C, Bjornstad PG, Fischer G, Smevik B, Lindberg HL. A novel method of hybrid intraoperative catheter-based closure of ventricular septal defects using the Amplatzer(R) PDA occluder. Catheter Cardiovasc Interv. 2011;77(4):557–63.CrossRefPubMedGoogle Scholar
  23. 23.
    Baird CW, Stern H, Watts L. Left atrial hybrid closure of muscular ventricular septal defects with the Amplatzer device. J Thorac Cardiovasc Surg. 2009;137(3):779–80.CrossRefPubMedGoogle Scholar
  24. 24.
    Veeram Reddy SR, Brenes JE, Forbess JM. Trans-semilunar valve hybrid technique for Amplatzer device closure of complex muscular ventricular septal defects during arterial switch operation. J Thorac Cardiovasc Surg. 2013;146(2):483–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Division of Pediatric CardiologyChildren’s Hospital, Louisiana State UniversityNew OrleansUSA
  2. 2.Division of Pediatric CardiologyChildren’s Hospital of Georgia, Georgia Regents UniversityAugustaUSA

Personalised recommendations