Key result
A hybrid approach using surgical right atriotomy and TEE guidance allowed for successful technical closure of a complex iatrogenic ventricular septal defect, though the patient died on day 14.
Why the study?
Postsurgical iatrogenic ventricular septal defects are challenging to treat, as surgical closure carries significant morbidity and mortality, while percutaneous approaches face access and positioning difficulties.
Case Report (n=1)
No
A hybrid approach combining surgical right atriotomy and TEE-guided transcatheter device placement can successfully close complex iatrogenic ventricular septal defects following septal myectomy.
Answers are grounded in this paper and cite their sources.
Hybrid closure of complex iatrogenic VSD may be technically feasible in select cases; leaves open survival benefit and optimal patient selection.
Treatment of postsurgical iatrogenic ventricular septal defects (VSDs) remains a challenge. Surgical closure is associated with significant morbidity and mortality. A peripheral accessed percutaneous approach is faced with difficulties of gaining adequate access and complex positioning in a beating heart. We report a case of using a hybrid approach to treat iatrogenic VSD with surgical right atriotomy and delivery of an Amplatzer system under direct visualization and transesophageal echocardiography guidance.
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Huang et al. (2020) conducted a case report in Iatrogenic ventricular septal defect (n=1). Hybrid approach with surgical right atriotomy and TEE-guided Amplatzer device delivery was evaluated on Successful closure of VSD. A hybrid approach using surgical right atriotomy and TEE guidance allowed for successful technical closure of a complex iatrogenic ventricular septal defect, though the patient died on day 14.
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