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Ann Thorac Surg 1999;67:1754-1758
© 1999 The Society of Thoracic Surgeons

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Original Articles

"Swiss cheese" septal defects: surgical closure using a single patch with intermediate fixings

^a Department of Cardiovascular and Pediatric Cardiac Surgery, Marie Lannelongue Hospital, Paris-Sud University, Paris, France

Accepted for publication December 17, 1998.

Address reprint requests to Dr Macé, Département de Chirurgie Cardiovasculaire et Cardiaque Pédiatrique, Hôpital Marie Lannelongue, 133, avenue de la Résistance, 92350 Le Plessis Robinson, France
e-mail: mace{at}ccml.com

Background. Residual ventricular septal defects and ventricular and septal dysfunctions are surgical drawbacks of "Swiss cheese" defects. We developed a technique that uses a single patch with intermediate fixings to cover the right side of the septum without producing a septal bulging, through a right atriotomy.

Methods. Since April 1993, 5 children with "Swiss cheese" defects have been operated on using this procedure (mean age, 17 ± 12 months). Three patients had associated lesions including tetralogy of Fallot, Taussig Bing heart, and mitral stenosis.

Results. There have been no early or late deaths. The mean follow-up time is 29 ± 18 months. All patients are asymptomatic. Echocardiography revealed either an intact septum (n = 4) or insignificant color jets at the apical portion of the septum (n = 1). The septal wall motion was preserved in 4 children and was hypokinetic in the fifth child.

Conclusions. This technique can be an additional tool to provide a secure closure of "Swiss cheese" defects even in the presence of associated cardiac lesions. Long-term consequences of this procedure on septal wall motion remain to be determined.

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