title: [A successful surgical repair of ventricular septal perforation following acute myocardial infarction in a 83-year-old man].
abstract: A 83-year-old man, who experienced a sudden severe malacia 13 days before, was admitted, complaining of dyspnea since 8 hours before. A loud systolic murmur of Levine IV/VI was audible on the left sternal border of the 4th intercostal space. The chest X-ray film demonstrated severe pulmonary congestion. The ECG showed abnormal Q waves in II, III, a VF and V1-5. The right heart catheterization revealed an intraventricular shunt from left to right and thus ventricular septal perforation (VSP) 13 days after acute anteroseptal-inferior myocardial infarction was diagnosed. Continuing an aggressive medical treatment with the intraaortic balloon pumping, an emergency operation for VSP was performed 2 days after the onset. A single Teflon patch was sutured on the left side of the septum around VSP (2.5 x 2.5 cm) and the ventricular free wall was closed including the patch with two felt strips. The patient survived through the operation and is doing well at the 11 months of follow-up. Twenty patients above 70 years old have been surgically treated with success for VSP after acute myocardial infarction in Japan. Our patient was the oldest.
authors.affiliation: Department of Cardiovascular Surgery, Osaka Prefectural Hospital.
authors.forename: Y
authors.initials: Y
authors.lastname: Morimoto
authors.forename: M
authors.initials: M
authors.lastname: Kato
authors.forename: N
authors.initials: N
authors.lastname: Ohkubo
authors.forename: T
authors.initials: T
authors.lastname: Hiranaka
authors.forename: K
authors.initials: K
authors.lastname: Ohnishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006342:Heart Rupture, Post-Infarction / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008297:Male; D008722:Methods