Intraoperative Device Closure of a Perimembranous Ventricular Septal Defect Using the Right Thoracic Ventricle Approach

Chen and colleagues retrospectively compared outcomes for children who underwent intraoperative device closure of a perimembranous ventricular septal defect (VSD) via two different approaches. VSD closure was performed through a minimal incision in the lower sternum in 52 patients and through a right transthoracic minimal incision in 46 patients. Patients were included if they had small to moderate sized VSDs with at least a 2 mm subaortic rim, mild pulmonary hypertension, and were over one year old, among other criteria. Postoperative complications were comparable between the groups, except for higher incidences of poor surgical wound healing and thoracic deformity in the patients with a lower sternal incision. Short-term follow-up revealed similar outcomes in both groups, and the authors conclude that the right thoracic ventricle approach is an acceptably safe alternative to a lower midline sternotomy for device closure of a perimembranous VSD in children.