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Double patch technique for closing acute ventricular septal perforation

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Abstract

Purpose

Ventricular septal perforation (VSP) is a rare but life-threatening complication of acute myocardial infarction (AMI). Even with assisted circulation heart failure often progresses quickly, and urgent surgical intervention is required to close the VSP. For several years, we have been performing a double patch closure technique using an equine pericardial patch. In this report, we present details of our patch closure technique and the VSP surgical results; we also examine the problems we encountered.

Methods

The present study was a review of nine patients who underwent our patch closure of VSP secondary to AMI. We used a large double-layered equine pericardial patch to close the VSP and did not exclude the infarction area from the left ventricular cavity. No necrotic myocardium was excised to avoid simultaneous excision of stunned myocardium.

Results

No patients died within 30 days of the surgery, and there were no in-hospital deaths. Over a mean clinical follow-up period of 4.5 years, no residual shunts were detected, and all patients were alive and had New York Heart Association functional class II.

Conclusion

Our patch closure technique was effective for closing VSPs securely. The operating times and cardiopulmonary bypass times were short, and blood loss was minimal. Our patch closure technique may improve the prognosis of VSP.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Kazuki Hisatomi, Kiyoyuki Eishi, Koji Hashizume, Tsuneo Ariyoshi, Shinichiro Taniguchi, Takashi Miura, Wataru Hashimoto & Seiji Matsukuma

  2. Nagasaki Medical Center, Nagasaki, Japan

    Masayoshi Hamawaki

  3. Sasebo City General Hospital, Sasebo, Japan

    Shiro Hazama

Authors
  1. Kazuki Hisatomi
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  2. Kiyoyuki Eishi
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  3. Masayoshi Hamawaki
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  4. Koji Hashizume
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  5. Shiro Hazama
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  6. Tsuneo Ariyoshi
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  7. Shinichiro Taniguchi
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  8. Takashi Miura
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  9. Wataru Hashimoto
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  10. Seiji Matsukuma
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Corresponding author

Correspondence to Kazuki Hisatomi.

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Hisatomi, K., Eishi, K., Hamawaki, M. et al. Double patch technique for closing acute ventricular septal perforation. Gen Thorac Cardiovasc Surg 58, 555–560 (2010). https://doi.org/10.1007/s11748-010-0632-9

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  • DOI: https://doi.org/10.1007/s11748-010-0632-9

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