Intraoperative echocardiography and double-patch device
sandwiching the septum
In 2004, Brizard and associates developed a unique technique in which
the discrete defects were located with intraoperative epicardial
echocardiography and transfixed with a guide wire inserted directly
through the right ventricular free wall.8 The multiple
ventricular septal defects were then sandwiched with custom made
multilayered double patches from both sides of the ventricular septum
under cardioplegic arrest via a right atriotomy. Multiple patches were
used for distantly located ventricular septal defects. For closely
related ventricular septal defects, oversized patches were used for
collective closure of the septal defects.8