Morphology of ventricular septal defects in complete transposition: Surgical implications

Mark Hoyer, J. R. Zuberbuhler, R. H. Anderson, P. Del Nido

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Postmortem examination of 62 hearts with complete transposition (concordant atrioventricular and discordant ventriculoarterial connections) and an accompanying ventricular septal defect was performed to determine the morphologic variability of ventricular septal defects and to explore the surgical implications of these defects. Particular attention was directed toward assessing alignment of the outlet septum relative to the muscular septum. Coronary arterial distributions were also evaluated, but specific patterns of distribution did not correlate with morphology of the defect. Of 49 hearts with a normally aligned outlet septum, there were 24 perimembranous, 21 muscular, and 2 doubly committed and juxtaarterial defects. Two hearts had both perimembranous and muscular defects. Twelve of the 21 muscular defects were 'central,' being surrounded entirely by muscle and located just below the leaflets of the pulmonary valve, and 9 were located in the inlet or apical trabecular septum. There were 13 hearts with malalignment of the outlet septum, anteriorly in 11 and posteriorly in 2. All with anterior malalignment had a subpulmonary defect that was perimembranous in 7 and muscular in 4. Both defects with posterior malalignment had a subaortic perimembranous defect. Because variations in morphology of a ventricular septal defect have a direct impact on selection of the most suitable surgical repair, specific operative approaches are discussed.

Original languageEnglish (US)
Pages (from-to)1203-1211
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume104
Issue number5
StatePublished - 1992
Externally publishedYes

Fingerprint

Ventricular Heart Septal Defects
Pulmonary Valve
Autopsy
Muscles

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Morphology of ventricular septal defects in complete transposition : Surgical implications. / Hoyer, Mark; Zuberbuhler, J. R.; Anderson, R. H.; Del Nido, P.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 104, No. 5, 1992, p. 1203-1211.

Research output: Contribution to journalArticle

Hoyer, Mark ; Zuberbuhler, J. R. ; Anderson, R. H. ; Del Nido, P. / Morphology of ventricular septal defects in complete transposition : Surgical implications. In: Journal of Thoracic and Cardiovascular Surgery. 1992 ; Vol. 104, No. 5. pp. 1203-1211.
@article{064db9a8c6164c5294dcada9fd9f24eb,
title = "Morphology of ventricular septal defects in complete transposition: Surgical implications",
abstract = "Postmortem examination of 62 hearts with complete transposition (concordant atrioventricular and discordant ventriculoarterial connections) and an accompanying ventricular septal defect was performed to determine the morphologic variability of ventricular septal defects and to explore the surgical implications of these defects. Particular attention was directed toward assessing alignment of the outlet septum relative to the muscular septum. Coronary arterial distributions were also evaluated, but specific patterns of distribution did not correlate with morphology of the defect. Of 49 hearts with a normally aligned outlet septum, there were 24 perimembranous, 21 muscular, and 2 doubly committed and juxtaarterial defects. Two hearts had both perimembranous and muscular defects. Twelve of the 21 muscular defects were 'central,' being surrounded entirely by muscle and located just below the leaflets of the pulmonary valve, and 9 were located in the inlet or apical trabecular septum. There were 13 hearts with malalignment of the outlet septum, anteriorly in 11 and posteriorly in 2. All with anterior malalignment had a subpulmonary defect that was perimembranous in 7 and muscular in 4. Both defects with posterior malalignment had a subaortic perimembranous defect. Because variations in morphology of a ventricular septal defect have a direct impact on selection of the most suitable surgical repair, specific operative approaches are discussed.",
author = "Mark Hoyer and Zuberbuhler, {J. R.} and Anderson, {R. H.} and {Del Nido}, P.",
year = "1992",
language = "English (US)",
volume = "104",
pages = "1203--1211",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Morphology of ventricular septal defects in complete transposition

T2 - Surgical implications

AU - Hoyer, Mark

AU - Zuberbuhler, J. R.

AU - Anderson, R. H.

AU - Del Nido, P.

PY - 1992

Y1 - 1992

N2 - Postmortem examination of 62 hearts with complete transposition (concordant atrioventricular and discordant ventriculoarterial connections) and an accompanying ventricular septal defect was performed to determine the morphologic variability of ventricular septal defects and to explore the surgical implications of these defects. Particular attention was directed toward assessing alignment of the outlet septum relative to the muscular septum. Coronary arterial distributions were also evaluated, but specific patterns of distribution did not correlate with morphology of the defect. Of 49 hearts with a normally aligned outlet septum, there were 24 perimembranous, 21 muscular, and 2 doubly committed and juxtaarterial defects. Two hearts had both perimembranous and muscular defects. Twelve of the 21 muscular defects were 'central,' being surrounded entirely by muscle and located just below the leaflets of the pulmonary valve, and 9 were located in the inlet or apical trabecular septum. There were 13 hearts with malalignment of the outlet septum, anteriorly in 11 and posteriorly in 2. All with anterior malalignment had a subpulmonary defect that was perimembranous in 7 and muscular in 4. Both defects with posterior malalignment had a subaortic perimembranous defect. Because variations in morphology of a ventricular septal defect have a direct impact on selection of the most suitable surgical repair, specific operative approaches are discussed.

AB - Postmortem examination of 62 hearts with complete transposition (concordant atrioventricular and discordant ventriculoarterial connections) and an accompanying ventricular septal defect was performed to determine the morphologic variability of ventricular septal defects and to explore the surgical implications of these defects. Particular attention was directed toward assessing alignment of the outlet septum relative to the muscular septum. Coronary arterial distributions were also evaluated, but specific patterns of distribution did not correlate with morphology of the defect. Of 49 hearts with a normally aligned outlet septum, there were 24 perimembranous, 21 muscular, and 2 doubly committed and juxtaarterial defects. Two hearts had both perimembranous and muscular defects. Twelve of the 21 muscular defects were 'central,' being surrounded entirely by muscle and located just below the leaflets of the pulmonary valve, and 9 were located in the inlet or apical trabecular septum. There were 13 hearts with malalignment of the outlet septum, anteriorly in 11 and posteriorly in 2. All with anterior malalignment had a subpulmonary defect that was perimembranous in 7 and muscular in 4. Both defects with posterior malalignment had a subaortic perimembranous defect. Because variations in morphology of a ventricular septal defect have a direct impact on selection of the most suitable surgical repair, specific operative approaches are discussed.

UR - http://www.scopus.com/inward/record.url?scp=0026455053&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026455053&partnerID=8YFLogxK

M3 - Article

C2 - 1434696

AN - SCOPUS:0026455053

VL - 104

SP - 1203

EP - 1211

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 5

ER -