Abstract
Objectives: Postinfarction ventricular septal rupture is fatal without surgical repair because of heart failure and secondary multiple organ failure. We investigated surgical results of postinfarction ventricular septal rupture and discussed the surgical strategy of postinfarction ventricular septal rupture.Methods: Twelve patients (mean age 71.3 ± 7.4 years, with range from 61 to 81 years) underwent surgical repair of postinfarction ventricular septal rupture, from 1990 to 1998 in our Institute. There were 6 women and 6 men. The ventricular septal rupture was anterior in 10 patients and inferior in 2. The operative technique for anterior ventricular septal rupture was reconstruction of the septum with a Dacron patch after infarctectomy, according to the method of Daggett et al. For posterior ventricular septal rupture, reconstruction of the septum with a Dacron patch after infarctectomy was performed and the ventricular incision was closed with a two-layer patch. Coronary artery bypass grafting was performed in 5 patients for severe proximal coronary artery stenosis using saphenous vein grafts.Results: Overall hospital mortality was 0%. A postoperative residual shunt was recognized in 3 patients, but all were well-controlled conservatively and re-operation was not needed. The patients have been followed up for a mean of 59.5 months. There have been two late deaths due to non-cardiac problems. Actuarial survival rate for the 12 patients was 90% at 1 year and 75% at 5 years.Conclusions: The Daggett method is simple and fast, and is an effective and reliable technique for the repair of ventricular septal rupture.
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Oyamada A, Queen FB. Spontaneous rupture of an interventricular septum following acute myocardial infarction with some clinico-pathological observations of survival in five cases. Paper presented at the Pan-Pacific Pathology Congress, Tripler U S Army Hospital, Honolulu, Hawaii, October 12, 1961.
Jonas V, Hyncik V, Shlumsky J, Chlumska A. Eight-year survival after perforation of ventricular septum in myocardial infarction. Acta Univ Carol 1970; 16: 133–44.
Cooley DA, Belmonte BA, Zeis LB, Schnur S. Surgical repair of ruptured interventricular septum following acute myocardial infarction. Surgery 1957; 41: 930–7.
Komeda M, Fremes SE, David TE. Surgical repair of postinfarction ventricular septal defect. Circulation 1990; 82 (Suppl IV): IV–243-7.
David TE. Surgical treatment of postinfarction ventricular septal rupture. Australas J Thorac Cardiovsc Surg 1992; 84: 306–12.
David TE, Laura Dale RN, Zhao Sun BA. Postinfarction ventricular septal rupture: repair by endocardial patch with infarct exclusion. J Thorac Cardiovasc Surg 1995; 110: 1315–22.
Tsuchiya K, Takazawa A, Iyori K, Yano T, Iida Y, Asahina T. A surgical case of pseudo-false aneurysm of “dissecting” aneurysm of the ventricle after myocardial infarction. Shinzou 1991; 23: 1385–9.
Sanders RJ, Kern WH, Blount SG Jr. Perforation of the interventricular septum complicating myocardial infarction: a case report of eight cases — one with cardiac catheterization. Am Heart J 1956; 51: 736–48.
Kirklin JW, Barratt-Boyes. Postinfarction ventricular septal defect. Cardiac Surgery (Second edition). 1993; 9: 403–13.
Daggett WM, Guyton RA, Mundth ED, Buckley MJ, Mcenany MT, Gold HK, Austen WG, et al. Surgery for post-myocardial infarct ventricular septal defect. Ann Surg 1977; 186: 260–71.
Daggett WM, Burwell LR, Lawson DW, Austen WG. Resection of acute ventricular aneurysm and ruptured interventricular septum after myocardial infarction. N Eng J Med 1970; 283: 1507–8.
Daggett WM. Surgical technique for early repair of posterior ventricular septal rupture. J Thorac Cardiovasc Surg 1982; 84: 306–12.
Skillington PD, Davies RH, Luff AJ, Williams JD, Dawkins KD, Conway N, Ross JK. Surgical treatment for infarct-related ventricular septal defects: improved early results combined with analysis of functional status. J Thorac Cardiovasc Surg 1990; 99: 798–808.
Yaginuma G, Ottomo M, Okada Y, Iijima Y, Abe K. Infarction exclusion technique for postinfarction ventricular septal defect (Eng abstr). J Jpn Assn Thorac Surg 1996; 44: 78–82.
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Furukawa, H., Tsuchiya, K., Ogata, K. et al. Surgical repair of postinfarction ventricular septal rupture. Jpn J Thorac Caridovasc Surg 48, 199–204 (2000). https://doi.org/10.1007/BF03218122
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DOI: https://doi.org/10.1007/BF03218122