A Modified Infarct Exclusion Repair of Posterior Postinfarction Ventricular Perforation: Triple-patch Technique for Postinfarction Ventricular Septal Perforation in 2 Female Patients

Tsutomu Sugimoto; Shinpei Yoshii; Kazuo Yamamoto; Kouki Takizawa; Akifumi Uehara; Masahiro Satoh; Sigetaka Kasuya

doi:10.5761/atcs.cr.09.01492

Case Reports

A Modified Infarct Exclusion Repair of Posterior Postinfarction Ventricular Perforation: Triple-patch Technique for Postinfarction Ventricular Septal Perforation in 2 Female Patients

Tsutomu Sugimoto, Shinpei Yoshii, Kazuo Yamamoto, Kouki Takizawa, Akifumi Uehara, Masahiro Satoh, Sigetaka Kasuya

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Keywords: posterior ventricular septal perforation, acute myocardial infarction, surgical treatment

JOURNAL FREE ACCESS

2011 Volume 17 Issue 1 Pages 90-93

DOI https://doi.org/10.5761/atcs.cr.09.01492

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Abstract

We describe a new technique for the early surgical repair of a posterior postinfarction ventricular septal perforation (VSP) in two consecutive female patients. The occurrence of a posterior VSP is rare, and its repair is technically difficult because the posteromedial papillary muscle is located adjacent to the intraventricular septum. This modification appears to prevent leaks to the right ventricle through the VPS with a single direct patch and the use of two equine pericardial patches to form a single endocardial pouch. The women were 77 and 62 years old, and the time between the onset of acute MI and surgery was 3 and 6 days. On preoperative catheterization, Qp/Qs was 4.18 and 4.01. Neither operative death nor residual shunting was observed.

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