Postinfarction Ventricular Septal Defect: Right Ventricular Approach鈥擳he Extended 鈥淪andwich鈥?Patch
- 作者：Tohru Asai ; MD ; PhD ; toruasai@belle.shiga-med.ac.jp ; Soh Hosoba ; MD ; Tomoaki Suzuki ; MD ; PhD ; Takeshi Kinoshita ; MD
- 关键词：post infarction ventricular septal defect ; myocardial infarction-mechanical complication ; cardiac surgical repair ; coronary artery disease ; operative technique
- 刊名：Seminars in Thoracic and Cardiovascular Surgery
- 出版年：2012
- 期刊代码：300_10430679
- 类别：med
- 出版时间：Spring, 2012
- 卷：24
- 期：1
- 页码：59-62
- 文件大小：1011 K
摘要
We introduce a novel technique of ventricular septal defect (VSD) closure through right ventricular incision and through the VSD. It should provide extended and better-anchored coverage of the VSD margin and create a completely leak-free 鈥渟andwich鈥?double patch by using large interrupted horizontal mattress sutures only, with no incision in the left ventricle wall. The patch is sutured better with large transseptal/transmural mattress sutures, minimizing perioperative risk of shunt recurrence. The second patch at the right ventricular side is easily placed. The patch in our method is considerably smaller than in the infarction exclusion technique. This method of VSD repair via right ventricular incision and trans-VSD approach is safe and simple, and it has so far given good, safe, and completely leak-free outcomes.