Double-patch repair of postinfarction ventricular septal defect.

Area of Science:

• Cardiology
• Cardiac Surgery
• Regenerative Medicine

Background:

• Postinfarction ventricular septal rupture is a severe complication of myocardial infarction.
• Inferior or inferoposterior myocardial infarction carries a higher risk of septal rupture.
• Surgical repair of ventricular septal defects (VSDs) can be challenging due to tissue friability.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel double-patch technique for repairing inferior postinfarction ventricular septal rupture.
• To assess the feasibility of using autologous pericardial patches for VSD closure.
• To determine the applicability of this technique in subacute or chronic phases of myocardial infarction.

Main Methods:

• The study involved 4 consecutive patients with inferior postinfarction ventricular septal rupture.
• A double-patch technique was employed, utilizing two autologous pericardial patches sutured to both sides of the septum.
• Repair was performed exclusively through a left ventriculotomy approach.

Main Results:

• Complete closure of the ventricular septal perforation was achieved in all 4 patients.
• No residual shunt was detected post-operatively in any of the cases.
• The double-patch technique facilitated direct closure of the defect.

Conclusions:

• The double-patch technique using autologous pericardium is a potentially effective method for repairing inferior postinfarction ventricular septal rupture.
• This approach may be particularly beneficial for VSDs associated with subacute or chronic inferoposterior myocardial infarction.
• Further investigation is warranted to confirm the long-term safety and efficacy of this surgical strategy.