[The investigation of surgical procedures for post infarcted ventricular septal defects: a comparison between Daggett and David method].
Post infarcted ventricular septal perforations (VSP) has diverse clinical and pathological manifestations and the surgical results in severe cases have not yet been satisfactory. In the past we had performed the procedure of Daggett. However since 1992 we have also introduced the procedure of infarction exclusion technique proposed by David which involves plastering the ventricular cavity in a large patch without infarcted myotomy. We reported 5 cases treated with David method, 5 cases with Daggett method, and their results were compared. There were four mortality cases in Daggett method and three in David method. No significant difference was observed regarding the surgical mortality. However, there were different post-operative features between the two groups. In Daggett method patients had prolonged heart failure and LOS. In David method patients, had no severe LOS, but residual shunt were recognized in two cases. We think that the emergence of residual shunt in David method was probably due to suturing without prior removal of the damaged fragile infarcted myocardium. In Daggett method there were death cases caused by LOS and postoperative heart failure but without residual shunts. Despite its recent growing popularity for treating VSP, our experience suggests that residual shunt is an important issue remains to be solved in David method.
Ichihara
T
T
Department of Cardiovascular Surgery, Tosei General Hospital, Aichi, Japan.
Asakura
T
T
Ishida
H
H
Sakai
Y
Y
Yasuura
K
K
D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods*; D001026:Coronary Artery Bypass; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D018658:Ventricular Septal Rupture / Q000601:surgery*