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Soichiro Kitamura
Choken Oyama
Kanji Kawachi
Shigeki Taniguchi
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Ann Thorac Surg 1984;38:640-643
© 1984 The Society of Thoracic Surgeons

Articles

A New Method of Closing the Ventricular Septal Defect in Corrected Transposition of the Great Arteries

Soichiro Kitamura, M.D.*, Choken Oyama, M.D., Kanji Kawachi, M.D., Yasuo Miyagi, M.D., Ryuichi Morita, M.D., Yoshiki Yamada, M.D., Shigeki Taniguchi, M.D.

Third Department of Surgery, Nara Medical College, Nara, Japan

Accepted for publication March 16, 1984.

* Address reprint requests to Dr. Kitamura, Third Department of Surgery, Nara Medical College, 840 Shijo-cho, Kashihara, Nara, Japan 634

A new method of closing a perimembranous malalignment ventricular septal defect (VSD) in corrected transposition of the great arteries (TGA) of the {S,L,L} type is presented. The method consists of combined approaches to the VSD through both a right atriotomy and an aortotomy without a ventriculotomy. The VSD is patched obliquely from the morphological right ventricular side of the septum, cranially through the aortic valve to the left ventricular side of the septum, caudally through the mitral valve. Although this method has been successfully applied in only one adult patient, some advantages may be expected: (1) prevention of trauma to the His bundle, which runs along the anterosuperior rim of the VSD on the left ventricular side; and (2) prevention of trauma to the tricuspid, mitral, and aortic valves without having to open the ventricles. We believe that this new method warrants a further trial as possibly better for closure of the VSD in corrected TGA of the {S,L,L} type.






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