The “Felt Sandwich Technique”
Several authors have described this technique, approaching the septum
through the transtricuspid route for multiple muscular defects located
just underneath the moderator band or at the apex of the heart, where it
is difficult to place sutures, and hence making the defects unsuitable
for direct closure.7,44,79 A 3F Nelaton catheter
(Bard, Haverhill, Mass) was railroaded through the septal defect. The
Nelaton catheter led an oversized circular polyester felt patch mounted
on a 4-0 braided polyester suture. The suture ends were then passed
through a slightly smaller polyester felt patch on the right ventricular
side of the septum. The braided polyester suture was then tied, thereby
sandwiching the septum between two polyester felt patches (Figure
8).7,44,79