Posterior ventricular septal rupture: an anatomical reconstruction

Area of Science:

• Cardiovascular Surgery
• Cardiac Repair Techniques
• Myocardial Infarction Complications

Background:

• Ventricular septal rupture (VSR) post-myocardial infarction (MI) is a rare but fatal complication.
• Conventional surgical repair methods for VSR present significant challenges and potential pitfalls.

Purpose of the Study:

• To present a novel, effective surgical technique for repairing ventricular septal rupture following posterior myocardial infarction.
• To detail a method that addresses the complexities and risks associated with conventional VSR repair.

Main Methods:

• A surgical technique utilizing two composite (felt/pericardium) patches: one internal for left ventricular geometry reconstruction and one external for infarctectomy repair.
• Employing continuous felt surfaces to sandwich myocardium for secure repairs.
• Utilizing specific transition stitches for robust anchoring at critical ventricular septum transition zones.

Main Results:

• The described technique achieved immediate hemostasis and restored a more anatomical left ventricular geometry.
• The method demonstrated a reduced incidence of systemic thromboembolism, residual VSD, and repair disruption in four patients.

Conclusions:

• This alternative surgical approach provides a secure and effective method for repairing post-MI ventricular septal rupture.
• The technique enhances patient outcomes by minimizing critical complications and improving cardiac function.