Embankment technique in extended sandwich patch repair for post-infarction ventricular septal rupture

Extended sandwich patch repair for post-infarction ventricular septal rupture is a surgical technique that closes the defect using two patches, with one on the right ventricular side and the other on the left ventricular side. In this technique, filling materials such as surgical glue are often used between the two patches. We routinely use BioGlue surgical adhesive as a filler. However, there are concerns regarding residual shunts because of incomplete closure of the defect and the risk of embolism caused by the glue leaking into the left ventricle. Therefore, we have developed a technique to create a "bank" using an absorbable hemostatic agent between the patch and the defect, aiming to secure defect sealing and prevent embolism caused by the glue. We have named this procedure the "embankment technique." In 11 consecutive cases treated with this procedure, no residual shunts or embolic events were observed.