Septal Repair
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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