title: Off-pump repair of a post-infarct ventricular septal defect: the 'Hamburger procedure'.
abstract: We report a novel off-pump technique for the surgical closure of post-infarct ventricular septal defects (VSDs). The case report describes the peri-operative management of a 76 year old lady who underwent the 'Hamburger procedure' for closure of her apical VSD. Refractory cardiogenic shock meant that traditional patch repairs requiring cardiopulmonary bypass would be poorly tolerated. We show that echocardiography guided off-pump posterior-anterior septal plication is a safe, effective method for closing post-infarct VSDs in unstable patients. More experience is required to ascertain whether this technique will become an accepted alternative to patch repairs.
authors.affiliation: Department of Cardiothoracic Surgery, Heart and Lung Centre, Wolverhampton, UK. tombarker@doctors.org.uk
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Barker
authors.forename: Alexander
authors.initials: A
authors.lastname: Ng
authors.forename: Ian S
authors.initials: IS
authors.lastname: Morgan
mesh_terms: D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D013536:Suture Techniques; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D011138:Polytetrafluoroethylene