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[Three cases of successful early operations of post-infarction ventricular septal perforation]
Insights
Early surgical repair of post-infarction ventricular septal perforation (VSP) can yield positive outcomes. Prompt intervention is crucial for patients experiencing VSP following myocardial infarction.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Post-infarction ventricular septal perforation (VSP) is a rare but serious complication of myocardial infarction.
- Early surgical intervention is often considered for VSP, but outcomes can vary.
Observation:
- This study reviewed three cases of VSP treated with early surgical repair.
- Patients presented with antero-septal infarction and perforation, undergoing surgery within 42-86 hours of VSP onset.
Findings:
- The surgical technique involved infarctectomy, septal reconstruction with a Teflon patch, and closure of ventricular defects.
- Despite initial postoperative challenges, all three patients showed positive recovery.
- This suggests that early surgical repair, when feasible, can be effective for VSP.
Implications:
- Early surgical intervention for post-infarction VSP, utilizing a specific reconstructive technique, may lead to favorable outcomes.
- This approach warrants consideration in select patients with VSP, emphasizing the importance of timely surgical management.
Abstract:
We reviewed three cases who underwent early operations for post-infarction ventricular septal perforation. Three patients were 56-year-old male, 66-year-old female, and 62-year-old female. These three cases had sustained antero-septal infarction with perforation. The periods to operations were 11 days, 86 hours, and 76 hours from the onsets of myocardial infarction. And 70 hours, 51 hours, and 42 hours from the onset of postinfarction ventricular septal perforation. Operations were performed after cardiac standstill using cold potassium cardioplegia and topical cooling. At first ventricular infarctectomy was performed and a large Teflon patch was used to create the septum after resection of the necrotic septum, and then resulting defect in the right and left ventricles was closed with Teflon strips and interrupted mattress sutures, incorporating the patch in the repair. Postoperative clinical courses were not smooth, but all the cases were going well. So we believed to get good results for early operations of post-infarction ventricular septal perforation, unless operative chances were lost.