The atrial or ventricular septum may have an abnormal opening between the right and left sides of the heart (ie, septal defect). Although most septal defects are congenital and are repaired during infancy or childhood, adults may not have undergone early repair or may develop septal defects as a result of myocardial in-farctions or diagnostic and treatment procedures.
Repair of septal defects requires general anesthesia and cardio-pulmonary bypass. The heart is opened, and a pericardial or syn-thetic (usually polyester or Dacron) patch is used to close the opening. Atrial septal defect repairs have low morbidity and mor-tality rates. When the mitral or tricuspid valve is involved, however, the procedure is more complicated because valve repair or replace-ment may be required and the heart failure may be more severe. Generally, ventricular septal repairs are uncomplicated, but the proximity of the defect to the intraventricular conduction system and the valves may make this repair more complex.
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