Right atrial approach with a single oversized patch on the
right ventricle (the septal obliteration technique)
Black and Cetin inserted a single large autologous pericardial patch and
composite patch of Dacron lined with preserved heterologous pericardium
respectively through the transtricuspid route without dividing the
moderator band.3,4
Seddio and associates also described this technique using a large
autologous pericardial patch after dividing the moderator
band.42 Kitagawa and associates used a
polytetrafluoroethylene patch, placed on the left ventricular side of
the septum after dividing the moderator band (Figures 6A,
6B).2,41
These techniques are useful when multiple discrete defects are present
in the posterior and apical parts of the septum, caudal to the moderator
band.1-4,41,42 Intraoperative transesophageal
echocardiography and cardioscopy from the left side of the septum via
the aortic root have been employed for identification of the defects
from the left side by these investigators.