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Ann Thorac Surg 2001;72:1800-1801
© 2001 The Society of Thoracic Surgeons

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Correspondence

Intraoperative location of muscular ventricular septal defects: Reply

^a Department of Cardiac Surgery, Lucile Packard Children’s Hospital, Stanford University School of Medicine, Stanford, CA 94305-5407, USA

To the Editor

The cardinal features of transventricular illumination for the surgical repair of isolated multiple muscular ventricular septal defects remains the atraumatic nature of the technique used to locate deficiencies in the apical muscular septum. As with other techniques the operator must be comfortable with the technologies available, ie, flexible or rigid transilluminators [1–3].

Doctor Wong and his colleagues describe the benefits of using the Surch-Lite (Aaron, St. Petersburgh, FL). Readily available, cheap, and flexible the scope can be positioned through a variety of portal sites. Similarly the cardioscope can be positioned through an aortotomy, atrial septal communication or the larger ventricular septal defects. Commonly used sizes vary from the mere 2.6 mm sinus scope to the standard arthroscopy scope of 5 mm. In addition to the transilluminating capabilities of either technique, cardioscopy can provide a magnified direct view of the ventricular septum thus allowing for either video detection or indirect transillumination of the defects.

The ultimate decision to proceed with the one-stage complete repair continues to reside with the surgeon. Either of the above technique provides a light in the otherwise dark reaches of the apical muscular septum enhancing the abilities of the surgeon who must decide, after all appropriate investigations, if all significant septal defects can be located and obliterated. I believe that further advances in surgical videoscopy will lead to an expanded role for videoscopic techniques used in the treatment of this and other complex congenital heart defects.

References

1. Rao V., Freedom R.M., Black M.D. Minimally invasive surgery with cardioscopy for congenital heart defects. Ann Thorac Surg 1999;68:1742-1745.[Abstract/Free Full Text]
2. Black M.D., Shukla V., Rao V., Smallhorn J.F., Freedom R.M. Repair of isolated multiple muscular ventricular septal defects: the septal obliteration technique. Ann Thorac Surg 2000;70:106-110.[Abstract/Free Full Text]
3. Black M.D. Lower ministernotomy for the repair of atrial septal defects. Ann Thorac Surg 2001;71:1066.[Free Full Text]

This Article 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): Michael D. Black Vinayak Shukla Vivek Rao Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Black, M. D. Articles by Freedom, R. M. Search for Related Content PubMed Articles by Black, M. D. Articles by Freedom, R. M. Related Collections Related Article