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Randomized Study to Compare Continuous and Interrupted Technique of Ventricular Septal Defect Closure

Praveen Nayak. , Rahul Singh , Praveen Nayak , Srikanth Bhumana , Shyam KST ,

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Journal of Cardiovascular Medicine and Surgery 6(3):p 213-219, July – September 2020. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.6320.8

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Rahul Singh, Praveen Nayak, Srikanth Bhumana, et. al. Randomized Study to Compare Continuous and Interrupted Technique of Ventricular Septal Defect Closure. J Cardiovasc Med Surg. 2020;6(3):213-219.
 

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Received : N/A         Accepted : N/A          Published : N/A

Abstract


Objective: To compare the outcome of continuous and interrupted surgical technique of Ventricular Septal Defect (VSD) closure with respect to the time taken for VSD closure, incidence of residual VSD and conduction abnormality. Methods: Randomized case control study was done with Pre-operative TTE and intraoperative TEE before
instituting CPB to confirm the type of VSD. Patients were put on Cardio pulmonary bypass using standard technique, all VSDs were approached though Right atrium. VSD closure was done using PTFE patch in all the
patient. 5–0 polypropylene double arm sutures were used in a total of 60 patients, 30 in each group with respect to continuous and interrupted technique of VSD closure. Residual VSD and conduction abnormality were assessed intra-operatively after termination of CPB, immediately post operatively in Intensive Care Unit (ICU) and after 1
month.

Results: The study included total 60 patients, 30 in each group as continuous and interrupted. The mean agegroup was 6.5 years. Most common cardiac abnormality detected in the study group was Tetralogy of Fallot (40%),25% patient had isolated VSD. Most commonly encountered VSD type was Perimembranous (86.67%). We observed
that 3 patients had residual VSD, out of these 2 were of continuous group with residual VSD size of less than 2 mm and 1 was of interrupted group with residual VSD of 3 mm. All residual VSDs were detected immediately after CBPbut there were no residual leaks seen in the post operative period. Only 58 patients were followed for 1 month with
no residual VSD. Only one patient of continuous group had complete heart block requiring pacemaker.

Conclusion: All types of VSDs can be closed by either of the technique. The residual VSD detected in the post bypass period in both the groups were statistically insignificant. In isolated VSD continuous technique is better in terms of less time required for VSD closure, less number of cardioplegia and lesser cardiopulmonary bypass (CPB)
time hence less myocardial damage due to ischemia and reperfusion, where as it does not give added advantage in patients with VSDs as well as associated anomalies as the total CPB time and number of cardioplegia delivered is unpredictable.



 

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Cite this article

Rahul Singh, Praveen Nayak, Srikanth Bhumana, et. al. Randomized Study to Compare Continuous and Interrupted Technique of Ventricular Septal Defect Closure. J Cardiovasc Med Surg. 2020;6(3):213-219.
 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.6320.8

Keywords

VSD Closure; TTE; PTFE Patch

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