Management of ventricular septal defect: A survey of practice in the United Kingdom

Background. A survey of pediatric cardiac surgeons was performed to establi sh current opinions in the United Kingdom concerning closure of ventricular septal defect. Methods. Questionnaires were sent to 14 pediatric cardiac centers in 1995 ( 16 surgeons, 100% response), and again in 1997 (20 surgeons, 100% response) . Results. Results are presented for 1997, with findings from 1995 shown in p arentheses. Eleven (6) surgeons used bypass exclusively, 9 (10) sometimes u sed circulatory arrest. Operative techniques were similar, although the mat erial used for the patch varied. Multiple defects were approached via the t ransatrial route by 18 (15), right ventriculotomy by 11 (7) and left ventri culotomy by 7 (6). The juxta-arterial defect was approached via the transpu lmonary route by 16 (13), a combination by 9 (11), transatrial by 10 (6), a nd transventricular by 9 (5). The most common indications for pulmonary art erial banding were "Swiss cheese" defect for 13 (13), and functionally sing le ventricle for 5 (6). Ventricular septal defect associated with coarctati on was repaired in two stages by 13 (10), a single stage by 5 (3), or eithe r by 1 (3). Conclusions. Pediatric cardiac surgeons in the United Kingdom demonstrate a uniform, evidence-based approach to the management of ventricular septal d efect. (Ann Thorac Surg 1999;68:983-8) (C) 1999 by The Society of Thoracic Surgeons.