Early and midterm outcomes of triple patch technique for postinfarction ventricular septal defects

Early and midterm outcomes were evaluated in patients who had postinfarction ventricular septal defect (VSD) and underwent VSD repair using the triple patch technique.

Twenty-one patients underwent VSD repair for postinfarction VSD between April 2004 and September 2015. A retrospective analysis of all in-hospital and postdischarge data was performed. In addition, we compared pre- and perioperative variables between survivors and nonsurvivors.

Thirty-day mortality was 23.8% (5 patients). Three patients died due to low output syndrome and 2 patients died due to sepsis. All of these patients were in cardiogenic shock preoperatively. Although 3 patients had a small residual shunt after surgery, the residual shunt disappeared 6 months after surgery in 1 patient and has been decreasing gradually in another. The mean follow-up was 43.5 ± 36.1 months. Overall survival rates (Kaplan-Meier method) at 3 and 8 years were 70.8% and 57.9%, respectively. Compared with survivors, nonsurvivors had a higher incidence of preoperative cardiogenic shock, higher incidence of chronic kidney disease and end-organ failure, and longer aortic crossclamp times during surgery.

Early and midterm outcomes of modified infarct exclusion using the triple patch technique are acceptable. This technique is safe and simple, and may be useful for reducing postoperative residual shunt.