HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Carl L. Backer Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Backer, C. L. Search for Related Content PubMed Articles by Backer, C. L.

Ann Thorac Surg 1999;67:758-759
© 1999 The Society of Thoracic Surgeons

---

Commentary

^a Division of Cardiovascular-Thoracic Surgery, Children’s Memorial Hospital, 2300 Children’s Plaza, M/C Box 22, Chicago, IL 60614, USA

e-mail: c-backer@nwu.edu

Invited commentary

Doctor Hisatomi and colleagues have addressed a very focused question, Is direct closure dangerous for treatment of doubly committed subarterial ventricular septal defect? They operated on 21 patients with conal ventricular septal defects, all of whom underwent direct closure of the ventricular septal defect with pledgeted sutures. Exposure was through the pulmonary artery, with the sutures tied at the base of the pulmonary valve. Indications for operation were aortic valve prolapse or aortic valve regurgitation, or both. There were no residual ventricular septal defects, and all patients had either reduction or nonprogression of their aortic insufficiency. They concluded that direct suture closure is safe and reliable for patients with doubly committed subarterial ventricular septal defects. The technique was particularly effective in younger patients (< 10 years of age), in that subgroup most children had no postoperative aortic regurgitation.

The approach to the patient with a doubly committed subarterial (conal, supracristal) . . . [Full Text of this Article]