Extended sandwich double-patch technique for ventricular septal rupture associated with inferior infarction

Ventricular septal rupture is one of the most critical complications of myocardial infarction. The key to surgical treatment for this condition is to reduce the risk of both postoperative left ventricular failure and residual shunt. Because the extended sandwich double-patch technique via a right ventricular incision does not require a left ventricular incision, postoperative left ventricular function is well maintained. Furthermore, because the septal rupture is tightly closed from both the left and right ventricles, the risk of residual shunts is minimized. In this video tutorial, we present the case of a 78-year-old woman who suffered from ventricular septal rupture after inferior wall infarction. Closure of the ventricular septal rupture by the extended sandwich double-patch method using a bovine pericardial patch through a right ventricular incision was carried out on the day after the onset of the myocardial infarction. The postoperative course was uneventful. There was no residual shunt and her postoperative heart function was well preserved.