[Early results of surgical repair of ventricular septal rupture].
OBJECTIVE
Ventricular septal rupture (VSR) is a lethal complication of acute myocardial infarction, and its operative results are far from good.


METHODS
Six patients who underwent operations for VSR in our department between 2001 and 2008. All these patients received coronary angiography, which showed 1-vessel disease in 4 patients, 2-vessel disease in 1, and 3-vessel disease in 1. The sites of myocardial infarction were the anteroseptal region in 3 patients and the inferoseptal region in 3.


RESULTS
Infarct exclusion was conducted in the 3 patients with anteroseptal infarction. Of the 3 patients with inferoseptal infarction, 1 underwent infarct exclusion and 2 Daggett operation. The number of in-hospital deaths was 3 (50%). Residual shunts were observed in 3 out of the 4 patients (75%) who had received infarct exclusion. Two of these 3 patients needed reoperation. The 2 patients with inferoseptal infarction who had undergone Daggett operation presented no residual shunts, and could be easily weaned from the cardiopulmonary bypass.


CONCLUSIONS
Because the infarct exclusion method frequently shows residual shunts, its technical modifications are required to improve the operative results. The Daggett method can be considered useful in patients with VSR after inferior myocardial infarction.
Ikenaga
Shigeru
S
Department of Cardiovascular Surgery, Tokuyama Central Hospital, Syunan, Japan.
Kamota
Takahiro
T
Okada
Haruhiko
H
D006348:Cardiac Surgical Procedures / Q000379:methods; D006342:Heart Rupture, Post-Infarction / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D016896:Treatment Outcome