2018 Volume 22 Issue 1 Pages 133-137
Interventricular septal hematoma (IVSH) is a very rare complication of congenital heart surgery. We report a case of IVSH after a patch closure of a ventricular septal defect (VSD) in a 1-year-old patient with tetralogy of Fallot. After weaning the patient off of cardiopulmonary bypass, an intra-operative transesophageal echocardiography (TEE) showed severe hypo-echogenic thickening of the interventricular septum beneath the VSD, with ventricular dysfunction that was diagnosed as IVSH. However, the hematoma did not obstruct the right or left ventricular outflow tracts based on visualization during the TEE, and the patient was hemodynamically stable. Therefore, we chose conservative therapy and did not proceed with surgical revision. The patient recovered well without any complications.
Intra-operative TEE monitoring allowed for the immediate detection of IVSH and contributed to the selection of conservative therapy. We conclude that intra-operative TEE plays an important role in congenital heart surgery.
