Simple Geometrical Infarct Exclusion Technique With a Single Patch for Postinfarction Ventricular Septal Perforation

• Published in: The Annals of thoracic surgery Vol. 89; no. 6; pp. 2049 - 2052
• Main Authors: Kobayashi, Toshiro, MD, Mikamo, Akihito, MD, Suzuki, Ryo, MD, Murakami, Masanori, MD, Shirasawa, Bungo, MD, Hamano, Kimikazu, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2010; Elsevier
• Subjects: Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiac Surgical Procedures - methods; Cardiology. Vascular system; Cardiothoracic Surgery; Female; Heart Rupture, Post-Infarction - surgery; Humans; Male; Medical sciences; Middle Aged; Pneumology; Prostheses and Implants; Surgery; 30; Infarct; Perforation; Anesthesia; Circulatory system; Technique; Cardiology; Patch
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2009.08.013

Six consecutive patients underwent emergency surgical repair of a postinfarction ventricular septal perforation. The principle of this technique is a simple three-dimensional repair with a nontailored square patch beforehand, which provides an adequate-sized pouch and prevents dehiscence of the patch being caused by excessive tension on the suture line. It also prevents a residual shunt. A single equine pericardium was sutured to the viable muscle circumferentially around the infarcted area to be excluded, after which the free edge of the patch was tailored and sutured in a pouch configuration. This technique seems to provide satisfactory early results in the acute phase of myocardial infarction.