Abstract:

Objective To observe the clinical outcomes of hybrid approach under direct vision in management of multiple muscular ventricular septal defects with associated cardiac malformations. Methods Forty patients with multiple muscular ventricular septal defects and associated cardiac malformations were enrolled, and hybrid approach under direct vision and cardiac malformation correction were performed with cardiopulmonary bypass. The results of operation and follow up were analyzed. Results Three patients died during operation, with the mortality of 7.5%. Pulmonary hypertension crisis occurred in 3 patients, and all were cured. No obvious residual shunt was observed in all patients. Patients were followed up for 6 months to 3 years, and no death occurred. Clinically insignificant residual shunt took place in 17 patients, and mild residual regurgitation was observed in 3 patients undergoing mitral valvuloplasty. Conclusion Hybrid approach under direct vision in management of multiple muscular ventricular septal defects, which can shorten the time of cardiopulmonary bypass and correct associated cardiac malformations at the same time, is convenient and safe, and may yield favorable mid-term and long-term outcomes.

Key words: hybrid approach, direct vision, multiple muscular ventricular septal defects, associated cardiac malformation