Late presentation of patients with large ventricular septal defect (VSD) and elevated pulmonary vascular resistance (PVR) is not uncommon in developing countries. Surgical VSD closure in these patients carries risks of persistent pulmonary hypertension, right ventricular failure, and mortality. Several techniques for creation of valved patches or fenestrated patches have been developed to address these issues. We have successfully used a simple and easily reproducible technique in which a cruciate fenestration is created in the patch used for VSD closure.
ZhouQLaiYWeiHSongRYafengWZhangH. Unidirectional valve patch for repair of cardiac septal defects with pulmonary hypertension. Ann Thorac Surg.1995;60(5):1245–1249.
2.
NovickWMGurbuzATWatsonDC. Double patch closure of ventricular septal defect with increased pulmonary vascular resistance. Ann Thorac Surg. 1998;66(5):1533–1537.
3.
NovickWMSandovalNLazorhysynetsVV. Flap valve double patch closure of ventricular septal defects in children with increased pulmonary vascular resistance. Ann Thorac Surg. 2005;79(1):21–28.
4.
ZhangBWuSLiangJ. Unidirectional mono valve homologous aortic patch for repair of ventricular septal defect with pulmonary hypertension. Ann Thorac Surg. 2007;83(6):2176–2181.
5.
TalwarSChoudharySKGargS. Unidirectional valved patch closure of ventricular septal defects with severe pulmonary arterial hypertension. Interact Cardiovasc Thorac Surg. 2012;14(6):699–702.
6.
SridharASubramanyanRLakshmiN. Do pre-operative hemodynamic data and reactivity test result predict the postoperative reversibility of pulmonary arterial hypertension in patients with large ventricular septal defect and borderline operability?Heart Asia. 2013;5(1):182–187.
