Surgical treatment with infarction exclusion technique and postoperative percutaneous cardiopulmonary support for a patient with ventricular septal perforation —A case report—

  • Atsushi Yamaguchi
  • Hideo Adachi
  • Junichi Tsuboi
  • Hitoshi Kamio
  • Masahiko Okada
  • Takashi Ino
Case Report
Received:
Accepted:

Abstract

A 76-year-old woman was referred to our hospital because of postinfarction ventricular septal perforation (VSP). VSP occurred twelve days after acute myocardial infarction and resulted in interventricular shunt with Qp/Qs of 4.8. Because she suffered from pulmonary edema and oligouria, she underwent emergent surgical treatment after application of the intraaortic balloon pump. The infarction involved whole of right ventricle and the inferoposterior wall of left ventricle, and the location of the perforation was infero-septum with the size of 10 × 6 mm. A bovine pericardial patch was tailored in a triangular shape of approximately 7 × 7 × 5 cm. The base of the patch was sutured to the fibrous annulus of the mitral valve and medial margin of the patch was sewn to healthy septal endocardium. And the lateral side of the patch was sutured to the posterior wall of the left ventricle. Because of difficulty in weaning of the cardiopulmonary bypass, a percutaneous cardiopulmonary support system (PCPS) was inserted via femoral artery and vein with a flow support of 2.0 L/min. After 4 days support of PCPS, improvement of right ventricular function was detected by echocardiogram and PCPS was removed. While PCPS support, low dose heparin to maintain ACT level around 150 seconds was continuously administered. Any complication including bleeding and thrombosis was not remarkable. The patient was discharged on the 53th postoperative day, and is now doing well.

Keywords

Inferior Myocardial Infarction Ventricular Septal Rupture Emergent Surgical Treatment Intraaortic Balloon Pump Percutaneous Cardiopulmonary Support 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 1998

Authors and Affiliations

  • Atsushi Yamaguchi
    • 1
  • Hideo Adachi
    • 1
  • Junichi Tsuboi
    • 1
  • Hitoshi Kamio
    • 1
  • Masahiko Okada
    • 1
  • Takashi Ino
    • 1
  1. 1.Department of Cardiovascular Surgery, Omiya Medical CenterJichi Medical SchoolSaitamaJapan

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