15．心室中隔欠損パッチ閉鎖

Ventricular Septal Defect Patch Closure

心室中隔欠損症（VSD）は先天性心疾患の中でもっとも頻度が高い疾患であり，単独の症例のみならず多くの複雑先天性心疾患に合併する心内病変である．VSD閉鎖術は小児心臓血管外科医にとって非常に重要な基本手術の一つであるが，安全で確実かつ迅速な手術を行うためには，その解剖学的構造の十分な理解と基本的手術手技の習得が必要である．

Ventricular septal defect is the most frequent congenital heart disease and it exists as an isolated form or combines with other complex cardiovascular malformations. Soto’s classification is based on the location and extension of the defect and it is most useful and comprehensive for a surgeon. Ventricular septal defect closure is one of the basic surgical procedures that a congenital heart surgeon must master first. In order to perform a perfect patch closure of the defect without making complications such as residual interventricular shunt, tricuspid valve regurgitation, or atrioventricular block, surgeon must acquire, ①preoperative and intraoperative accurate assessment and understanding of the anatomical features of the defect, ②effective intraoperative exposure of the defect, and ③safe and assured stitch and ligation.