Perventricular closure of ventricular septal defect (VSD)

Perventricular closure of VSD Perventricular closure of VSD is a hybrid procedure. Cardiac surgeon opens the chest and the cardiologist passes a sheath through the right ventricle to achieve a device closure. Heart is exposed through a lower partial sternotomy. The advantage is that cardiopulmonary bypass is not needed. Intra operative trans esophageal echocardiography is used to confirm the size of the defect, its rim from the aortic valve and the function of the aortic valve. The location of the ventricular septal defect is determined intraoperatively by palpating the region over the right ventricle with maximum intensity of the thrill due to left to right shunt. The site for puncture is further confirmed by trans esophageal echocardiography (TEE). The device closure system has a trocar for introduction through the right ventricle, a dilator, sheath for delivery of device and the device VSD closure. The trocar is introduced through a purse string suture for control of bleeding. Guide wire and sheath introduction is under continuous TEE guidance. Sheath is de-aired by allowing a back bleed. The device occluder’s right ventricular disc is secured by a suture to facilitate retrieval if needed. After accurate device positioning, the suture can be cut and removed. TEE confirms the device position as well the good functioning of aortic and tricsupid valves. Cardiac rhythm is also checked to exclude conduction disturbances before the device delivery is established. As with o...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology device occluder guide wire Perventricular closure of ventricular septal defect Perventricular closure of VSD TEE guidance trans esophageal echocardiographic guidance Source Type: blogs