A ONE-WAY VALVED ATRIAL SEPTAL PATCH - A NEW SURGICAL TECHNIQUE AND ITS CLINICAL-APPLICATION

Patients who undergo surgical repair of congenital heart defects, char acterized by a hypoplastic right ventricle or high pulmonary vascular resistance, are at high risk for the development of postoperative righ t heart failure, This risk may discourage the surgical team from carry ing out a biventricular or complete repair in such patients, To reduce the risk for right heart failure, we developed a one-way, valved, atr ial septal patch to serve as an artificial one-way foramen ovale and t ested it in an animal model, By permitting right-to-left shunt, this d evice decompresses the failing right ventricle and maintains systemic cardiac output, The device has been used in 15 patients divided into t hree different groups: group 1 (n = 8), patients with a hypoplastic ri ght ventricle and pulmonic stenosis or atresia, seven of whom underwen t a biventricular repair; group 2 (n = 5), patients with evidence of p ulmonary disease after longstanding left-to-right shunt caused by a co rrectable atrial or ventricular septal defect, all of whom had a compl ete repair; group 3, two patients with acute right heart failure in wh om the device was used as a last option of treatment to wean them from cardiopulmonary bypass, This article presents our data in regard to t he use of the one-way, valved, atrial septal patch and the indications for its clinical use.