Transatrial repair of ventricular septal defects with reference to their anatomic classification.

A consecutive series of 50 children undergoing elective operations for ventricular septal defect (VSD) is presented. Atriotomy was performed routinely. Repair of the defect through the tricuspid valve was attempted in all cases and achieved in 72 percent. There was a 24 percent incidence of right bundle branch block. All patients improved symptomatically after the operation. The mortality rate was 4 percent. The right atrial route is considered to be preferable as a primary approach and has no disadvantages.