15．心室中隔欠損パッチ閉鎖

Patch Closure of the Ventricular Septal Defect

心室中隔欠損症（ventricular septal defect：VSD）は先天性心疾患の中でもっとも頻度が高い疾患である．VSDパッチ閉鎖術はsimple VSDのみならず，Fallot四徴症（TOF），完全型房室中隔欠損症などの多くの複雑先天性心疾患の心内修復に多用される非常に重要な基本手術の一つである．VSDと一口にいっても，形態，サイズは異なり，患者の年齢によっても様相が異なるが，確実・安全かつ迅速な手術を行うためには，その解剖学的構造の理解と基本的な手術手技の習得が必須である．

Ventricular septal defect （VSD） is the most common congenital heart disease. The “VSD patch closure” is a very important and basic surgery frequently used for not only simple VSD but also many complex congenital heart defects such as tetralogy of Fallot and complete atrioventricular septal defect. To perform a complete VSD closure without any complications such as atrio-ventricular block, residual VSD, tricuspid valve regurgitation, and right ventricular outflow obstruction, the surgeons must understand the anatomical features of the various type of VSD and perform gentle stitch and ligation.