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The Annals of Thoracic Surgery, Vol 24, 537-543, Copyright © 1977 by The Society of Thoracic Surgeons
C Zavanella, H Matsuda, F Jara and S Subramanian
Multiple muscular ventricular septal defects were closed through an apical
left ventriculotomy in 11 patients. The patients were divided into two
groups: Group 1, 8 patients who had transposition of the great arteries,
and group 2, 3 patients without transposition. There were 4 deaths in Group
1 and non in Group 2. Two of the deaths were caused by a hypoplastic right
ventricle, 1 by airway obstruction, and 1 by heart failure and pulmonary
edema in a patient who had additional unrecognized muscular defects. An
apical left ventriculotomy provides excellent exposure of the septum. The
field is not obscured by trabecular bands or papillary muscles. Although 1
patient died because of residual VSDs, this approach, compared with
previously described methods, minimizes the risk of unrecognized defects.
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