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Ann Thorac Surg 1999;68:983-988
© 1999 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Management of ventricular septal defect: a survey of practice in the United Kingdom

Anna F. Merrick, FRCSa, Manisha Lal, MBMSa, Robert H. Anderson, MDa, Darryl F. Shore, FRCSa

a Departments of Pediatrics and Surgery, National Heart and Lung Institute, Imperial College School of Medicine, and Royal Brompton and Harefield NHS Trust Hospitals, London, England, United Kingdom

Address reprint requests to Prof Anderson, Section of Paediatrics, Royal Brompton Campus, National Heart and Lung Institute, Imperial College School of Medicine, Dovehouse St, London SW3 6LY, England
e-mail: r.anderson{at}ic.ac/uk

Background. A survey of pediatric cardiac surgeons was performed to establish current opinions in the United Kingdom concerning closure of ventricular septal defect.

Methods. Questionnaires were sent to 14 pediatric cardiac centers in 1995 (16 surgeons, 100% response), and again in 1997 (20 surgeons, 100% response).

Results. Results are presented for 1997, with findings from 1995 shown in parentheses. Eleven (6) surgeons used bypass exclusively, 9 (10) sometimes used circulatory arrest. Operative techniques were similar, although the material used for the patch varied. Multiple defects were approached via the transatrial route by 18 (15), right ventriculotomy by 11 (7) and left ventriculotomy by 7 (6). The juxta-arterial defect was approached via the transpulmonary route by 16 (13), a combination by 9 (11), transatrial by 10 (6), and transventricular by 9 (5). The most common indications for pulmonary arterial banding were "Swiss cheese" defect for 13 (13), and functionally single ventricle for 5 (6). Ventricular septal defect associated with coarctation was repaired in two stages by 13 (10), a single stage by 5 (3), or either by 1 (3).

Conclusions. Pediatric cardiac surgeons in the United Kingdom demonstrate a uniform, evidence-based approach to the management of ventricular septal defect.






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