Double-patch repair by a bilateral ventriculotomy for postinfarction ventricular septal defect

Area of Science:

• Cardiovascular Surgery
• Cardiac Repair Techniques
• Ventricular Septal Defect Management

Background:

• Postinfarction ventricular septal defect (VSD) repair is complex, often resulting in residual shunts and high mortality.
• The infarct exclusion technique is a surgical option, but its efficacy with different approaches requires evaluation.

Purpose of the Study:

• To assess a modified infarct exclusion technique for postinfarction VSD repair.
• To compare the outcomes of a biventricular versus a left ventricular approach.

Main Methods:

• Retrospective review of 19 consecutive patients undergoing VSD infarct exclusion (2002-2011).
• Comparison of a biventricular (B group, n=6) and left ventricular (L group, n=13) approach via univariate analysis.

Main Results:

• Overall 30-day mortality was 15.8% with no significant difference between groups (p=0.94).
• No postoperative residual shunt was observed in the biventricular group (p=0.21).
• Five-year survival was 79%, with no late deaths in the biventricular group (p=0.14).

Conclusions:

• The infarct exclusion technique with a biventricular approach is a safe and effective method for postinfarction VSD repair.
• This approach appears to reduce surgical mortality and prevent VSD recurrence.