naa a22 4500 510727905 CHVBK 20180411082942.0 cr unu---uuuuu 180411e20130701xx s 000 0 eng 10.1007/s11748-013-0267-8 doi (NATIONALLICENCE)springer-10.1007/s11748-013-0267-8 Techniques and results in the management of multiple muscular trabecular ventricular septal defects [Elektronische Daten] [Tetsuya Kitagawa, Takashi Kitaichi, Mikio Sugano, Hirotsugu Kurobe] The management of patients with multiple muscular trabecular ventricular septal defects (VSDs) remains controversial. In the past two decades, innovative techniques including a right ventricular apical infundibulotomy and transcatheter, intraoperative and perventricular device closure have been exploited, and essential right atrial approach and limited apical left ventriculotomy have also been refined. However, specific management guidelines for this difficult disease have not been established. In this article, the benefits and drawbacks of each technique are reviewed and discussed. Primary repair for infants with multiple muscular trabecular VSDs was associated with good late outcomes. The right atrial approach was satisfactory for all muscular VSDs, excluding apical defects that were well seen through a limited apical ventriculotomy. Surgical closure of apical defects could be achieved safely and completely in early infancy through a limited apical left ventriculotomy or a right ventricular apical infundibulotomy. Further follow-up and prudent evaluations of ventriculotomy-associated morbidities are needed. Pulmonary artery banding should be limited to a small infant with complex associated defects. Percutaneous device closure, the most desirable option, is impractical due to limitations between the delivery system and access route. Intraoperative device closure appears less successful than device closure in the catheterization laboratory. Perventricular device closure has a significant advantage of being a non-bypass procedure approach. A less invasive strategy for "true” Swiss cheese septum is needed. All may have an important role, and results obtained by using these techniques are encouraging. These hybrid approaches will promise future success on management guidelines of multiple muscular trabecular VSDs. The Japanese Association for Thoracic Surgery, 2013 Multiple muscular trabecular ventricular septal defects nationallicence "Oversized” patch technique nationallicence Apical left ventriculotomy nationallicence Right ventricular apical infundibulotomy nationallicence Device closure nationallicence Kitagawa Tetsuya Department of Cardiovascular Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, 770-8503, Tokushima, Japan aut Kitaichi Takashi Department of Cardiovascular Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, 770-8503, Tokushima, Japan aut Sugano Mikio Department of Cardiovascular Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, 770-8503, Tokushima, Japan aut Kurobe Hirotsugu Department of Cardiovascular Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, 770-8503, Tokushima, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/7(2013-07-01), 367-375 1863-6705 61:7<367 2013 61 11748 https://doi.org/10.1007/s11748-013-0267-8 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-013-0267-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kitagawa Tetsuya Department of Cardiovascular Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, 770-8503, Tokushima, Japan aut NATIONALLICENCE 700 1- Kitaichi Takashi Department of Cardiovascular Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, 770-8503, Tokushima, Japan aut NATIONALLICENCE 700 1- Sugano Mikio Department of Cardiovascular Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, 770-8503, Tokushima, Japan aut NATIONALLICENCE 700 1- Kurobe Hirotsugu Department of Cardiovascular Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, 770-8503, Tokushima, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/7(2013-07-01), 367-375 1863-6705 61:7<367 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer