modality of treatment is also indicated for neonates with complex defects and large muscular VSDs, where a one-stage repair via sternotomy can be applied (10). Our case, first in Turkey, was closed successfully by perventricular closure using Amplatzer muscular VSD device. Conclusion We conclude that Amplatzer muscular VSD occluder seems to be a safe and effective device for closure of muscular VSDs. Further clinical trials with this device are underway. This hybrid technique involving both pediatric cardiologists and cardiothoracic surgeons can be utilized to close muscular VSDs even in small babies with ease. References 1. Myhre U, Duncan BW, Mee RB, Joshi R, Seshadri SG, Herrera-Verdugo O, et al. Apical right ventriculotomy for closure of apical ventricular septal defects. Ann Thorac Surg 2004; 78: 204-8. 2. Bridges ND, Perry SB, Keane JF, Goldstein SA, Mandell V, Mayer JE Jr, et al. Preoperative transcatheter closure of congenital muscular ventricular septal defects. N Eng J Med 1991; 324: 1312-7. 3. Thanopoulos BD, Tsaousis GS, Konstadopoulou GN, Zarayelyan AG. Transcatheter closure of muscular ventricular septal defect occluder: Initial clinical application in children. J Am Coll Cardiol 1999; 33: 1395-9. 4. Hijazi ZM, Hakim F, Al-Fadley F, Abdelhamid J, Cao QL. Transcatheter closure of single muscular ventricular septal defects using the Amplatzer Muscular VSD Occluder: Initial results and technical considerations. Cathet Cardiovasc Interv 2000; 49:167-72. 5. Bilgiç A, Çeliker A, Özkutlu S, Ayabakan C, Karagöz T, Öcal T. Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial duct. Turk J Ped 2001; 43: 12-8. 6. Arora R, Trehan V, Thakur AK, Mehta V, Sengupta PP, Nigam M. Transcatheter closure of congenital muscular ventricular septal defect. J Interven Cardiol 2004; 17: 109-15. 7. Holzer R, Balzer D, Cao QL, Lock K, Hijazi ZM. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder. J Am Coll Cardiol 2004; 43: 1257-1263. 8. Amin Z, Berry JM, Foker JE, Rocchini AP, Bass JL. Intraoperative closure of muscular ventricular septal defect in a canine model and applicability of the technique in a baby. J Thorac Cardiovasc Surg 1998; 115: 1374-6. 9. Amin Z, Gu X, Berry JM, Titus JL, Gidding SS, Rocchini AP. Perventricular closure of ventricular septal defects without cardiopulmonary bypass. Ann Thorac Surg 1999; 68: 149-54. 10. Rodes J, Piechaud JF, Ouaknine R, Hulin S, Cohen L, Magnier S, et al. Transcatheter closure of apical ventricular muscular septal defect combined with arterial switch operation in a newborn infant. Catheter Cardiovasc Interv 2000; 49: 173-6. Bilateral common peroneal nerve palsy following cardiac surgery Kardiyak cerrahi sonras› bilateral komon peroneal sinir paralizi Berrin Durmaz, Funda Atamaz, Arzu On Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ege University, ‹zmir, Turkey Introduction Although cardiac surgery improves the life expectancy in the patients with severe heart diseases, the post-operation period is associated with severe complications (1-4). Even though peripheral nervous system complications are less frequent and usually less severe than others, they have an importance due to a source of additional postoperative disability. In this report, we presented 3 cases with bilateral common peroneal nerve palsy (CPNP) following cardiac surgery. Case 1 A 52-year-old man was referred to our clinic for bilateral foot droop with sensory loss on the lateral aspect of his legs and feet. The patient underwent a three-vessel coronary artery bypass graft surgery 3 weeks ago and his complaints started immediately after surgery. He had no concomitant disease except 11 years’ history of diabetes. The patient’s examination revealed weakness of feet dorsiflexion/eversion (2-/5) and diminished sensation on the dorsum of the feet and anterolateral side of both calves. Nerve conduction studies showed prolonged latency and slow velocity around the fibula head as compared with distal segment for common peroneal nerve. Small compound muscle action potentials from the extensor digitorum brevis muscles were observed by both proximal and distal stimulation. Needle electromyography (EMG) of bilateral tibialis anterior and peroneus longus muscles revealed motor unit potentials of normal amplitude, duration, and phasicity; increased insertional activity, 2+ fibrillations, 2+ positive sharp waves and reduced recruitment. An isolated partial lesion of CPN bilaterally was diagnosed. The patient started in a physical therapy and rehabilitation program (PTRP) including active assistive ranges of motion exercises and electrical stimulation for 5 days per week for 1 month, and then home exercise program was prescribed. In addition to foot orthosis, correct positions of ankles were described. At the 3 rd and 6 th months, there was a significant improvement clinically. In addition, repeated needle EMG showed reinnervation of motor units via axonal regeneration. Address for Correspondence/Yaz›flma Adresi: Dr. Funda Atamaz, Ege Üniversitesi T›p Fakültesi Fiziksel T›p ve Rehabilitasyon Anabilim Dal›, ‹zmir, Turkey Phone: + 90 232 390 43 35 Fax: +90 232 388 19 53 E-mail: atamaz_02@yahoo.com Anadolu Kardiyol Derg 2008; 8: 306-14 Olgu Sunumlar› Case Reports 313