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J Thorac Cardiovasc Surg 2008;135:702-703
© 2008 The American Association for Thoracic Surgery

Brief Communication

A modified infarct exclusion technique: Triple-patch technique for postinfarction ventricular septal perforation

Tsutomu Sugimoto, MD*, Shinpei Yoshii, MD, PhD, Kazuo Yamamoto, MD, PhD, Kenji Sakakibara, MD, PhD, Yasunori Iida, MD, PhD, Akifumi Uehara, MD, Takehito Mishima, MD, Sigetaka Kasuya, MD, PhD

Department of Cardiovascular Surgery, Tachikawa Medical Center, Nagaoka, Japan

Received for publication August 14, 2007; accepted for publication November 8, 2007.

* Address for reprints: Tsutomu Sugimoto, MD, Department of Cardiovascular Surgery, Tachikawa Medical Center, 3-2-11, Kanda-Machi, Nagaoka, Niigata, 940-8621, Japan. (Email: tsugimoto-cvs@umin.ac.jp).

The first 20% of the full text of this article appears below.

Postinfarction ventricular septal perforation (VSP) remains an important complication of myocardial infarction. The prevalence is approximately 1% to 2% among patients with acute myocardial infarction, and it is often fatal unless surgical treatment is performed. Despite numerous improvements in surgical technique, the mortality remains about 19% to 40%.1Go Perioperative low-output syndrome and residual shunt are associated with a poor outcome. We operated on 4 patients with our simple technique that minimizes residual shunting.

Materials and Methods

Operative Technique
Cardiopulmonary bypass was established, and myocardial revascularization if necessary was performed on the beating heart before repair of the VSP. The heart was then arrested with a cardioplegic solution, and repair was done through a longitudinal left ventriculotomy in the infarcted area, about 1 to 2 cm away from the left anterior descending coronary artery. First, a tailored small bovine pericardial patch was used to close the VSP directly with a running 3-0 polypropylene suture. Then two bovine pericardial patches were cut into rectangular shapes. . . . [Full Text of this Article]




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 Interact CardioVasc Thorac SurgHome page
T. Shimamoto, A. Marui, Y. Saji, and M. Komeda
Infarction-exclusion technique with the on-pump beating heart approach for ventricular septal perforation
Interact CardioVasc Thorac Surg, December 1, 2008; 7(6): 1207 - 1209.
[Abstract] [Full Text] [PDF]


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