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VENTRICULAR SEPTAL DEFECT

(SURGICAL CORRECTION)

REASON FOR VISIT

• Ventricular septal defect


• Heart murmur
• The signs and symptoms of congestive heart failure
• Slowed growth

RISK ASSESSMENT

• Premature baby
• Low birth weight

PREPARATION OF THE PATIENT

• Blood tests
• Echocardiogram
• Chest X-Ray
• Cardiac catheterization
• Doppler color flow
• Two-dimensional echocardiography
• CT scan
• MRI
• Angiography
• Three-dimensional echocardiography
• Antibiotics are given before surgery
• Nothing is taken by mouth 6 hrs before surgery

ANESTHESIA
• General
• Local

POSITION OF THE PATIENT

Supine position

PROCEDURE

OPEN
• With the patient in the supine position, he/she was prepared
from shin to knees and draped in a sterile field
• A right common femoral artery vein was then exposed through a
longitudinal incision in the right groin and prepared for
cardiopulmonary bypass.
• Incision was given at mid sternal line
• A sternotomy was performed
• The patient was heparinized and then a pursestring suture was
placed in the right atrium superior and inferior just above the
superior and inferior vena cava.
• A percutaneous catheter for arterial return was placed using
Seldinger technique through exposed right femoral artery and
then two 3-mm catheters were inserted with two pursestring
sutures in the right atrium just superior to inferior vena cava.
• The child was placed on cardiopulmonary bypass and another
pursestring suture was placed in the right superior pulmonary
vein and a catheter was placed for suction in the left atrium.
• The heart suspended in a pericardial cradle.
• A cardiectomy was then performed by starting in the right
atrium.
• The ventricular septal defect was _______ in size.
• The Dacron / Gore-Tex patch was placed over the VSD and
sutured it.
• The incisions to the heart were sutured.
• The child was gradually overtime weaned from cardiopulmonary
bypass.
• Chest tubes were inserted into the mediastinum
• Chest incision was closed with sutures

CARDIAC CATHETERIZATION

• With the patient in the supine position, rt groin was prepared


and draped in a sterile field
• Local anesthesia was given with _____
• Small incision was given at the site of catheter introduces
• Catheter was inserted right femoral artery in the leg
• Through the fluoroscopy guidance catheter was passed to the
heart.
• A special implant, shaped into two disks formed of flexible wire
mesh was positioned into the hole in the septum.
• Catheter was removed
• The site of incision was closed with sutures.
DURATION
_______hrs

AFTER PROCEDURE

• Patient was shifted to the I.C.U


• Patient was on ventilation
• Heart rate, oxygenation, and the ECG are monitored.
• Chest tubes are checked to ensure that they're draining
properly and there is no hemorrhage.

POSTOPERATIVE CARE

• Take antibiotic medicine as prescribed


• Take pain medication
• Start chest exercises and chest physical therapy

COMPLICATIONS

• Infection
• Endocarditis
• Congestive heart failure
• Irregular heartbeat
• Kidney damage
• Lung blood clot
• Low blood pressure
• Hemorrhage
• Cardiac arrest