Postinfarction inferior ventricular septal rupture: surgical repair through the right atrium.
Operative mortality of inferior postinfarct ventricular septal rupture (VSR) remains high. Previous reports have described a transatrial approach to access the VSR avoiding a ventriculotomy, thereby reducing the potential risks of myocardial damage, hemorrhage, and ventricular arrhythmias. The transatrial right ventricular patch or direct suture repair, however, is exposed to the left-to-right pressure gradient and is at risk of residual shunting. In this report, a transatrial approach is used, with direct suture of the VSR, patch exclusion of the right ventricle, and biological glue instillation to protect the patch from left ventricular pressures.
Moorjani
Narain
N
Department of Cardiothoracic Surgery, Southampton General Hospital, Southampton, United Kingdom. narain.moorjani@doctors.org.uk
Viola
Nicola
N
Haw
Marcus
M
D000368:Aged; D006348:Cardiac Surgical Procedures; D006325:Heart Atria / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D013997:Time Factors; D014261:Tricuspid Valve / Q000601:surgery; D018658:Ventricular Septal Rupture / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery