Early repair of postinfarction ventricular septal defect with gelatin-resorcin-formol biological glue.
BACKGROUND
Early surgical repair of postinfarction ventricular septal defect has improved early mortality rate. Mortality remains high in patients presenting within 1 week of infarction, or when rupture has occurred in the inferior part of the septum.


METHODS
We describe a surgical technique for repair of postinfarction ventricular septal defect that involves no infarctectomy: continuous suturing of a bovine pericardial patch to healthy myocardium around the infarcted area and use of gelatin-resorcin-formol biological glue as a sealant between the patch and the interventricular septum.


RESULTS
We have used this technique successfully in 3 consecutive patients in whom repair was performed within 1 week of myocardial infarction. The rupture of the interventricular septum was located anteriorly in 2 patients and inferiorly in the other. They all made an uneventful recovery, and at follow-up there was no evidence of residual shunt.


CONCLUSIONS
This technique can be a useful adjunct to the surgical management of this difficult group of patients.
Musumeci
F
F
Department of Cardiac Surgery, University Hospital of Wales, Cardiff, United Kingdom.
Shukla
V
V
Mignosa
C
C
Casali
G
G
Ikram
S
S
D000368:Aged; D000818:Animals; D009202:Cardiomyopathies / Q000473:pathology / Q000601:surgery; D002315:Cardiopulmonary Bypass; D002417:Cattle; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005557:Formaldehyde / Q000627:therapeutic use*; D005780:Gelatin / Q000627:therapeutic use*; D006342:Heart Rupture, Post-Infarction / Q000473:pathology / Q000601:surgery*; D006346:Heart Septum / Q000473:pathology / Q000601:surgery*; D006352:Heart Ventricles / Q000473:pathology / Q000601:surgery; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009203:Myocardial Infarction / Q000601:surgery; D010496:Pericardium / Q000637:transplantation; D012118:Resorcinols / Q000627:therapeutic use*; D015996:Survival Rate; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014183:Transplantation, Heterologous
D004338:Drug Combinations; D012118:Resorcinols; D014014:Tissue Adhesives; C027813:gelatin-resorcinol-formaldehyde tissue adhesive; D005557:Formaldehyde; D005780:Gelatin