title: Midterm results of the "sandwich technique" via a right ventricle incision to repair post-infarction ventricular septal defect.
abstract: BACKGROUND
  Residual shunting and mortality are problems associated with current surgical repair techniques for post-infarction ventricular septal defects.
  
  
  METHODS
  We describe the mid-term results of the "sandwich technique" to repair a post-infarction ventricular septal defect (VSD), performed via a right ventricle incision. Application of direct ultrasonography to the right ventricular wall enables a surgeon to visualize the region, perform an appropriate incision into the right ventricle, and perform a trabecula resection. One patch is placed on the left ventricular (LV) side and the other on the right ventricular (RV) side of the VSD. The VSD is sealed with gelatin-resorcin-formalin (GRF) glue between the two patches.
  
  
  RESULTS
  We had seven consecutive patients. The sandwich technique resulted in geometric preservation of the LV shape. There were no significant leaks, no mortality within a thirty-day postoperative period, and no bleeding problems. Hospital mortality was 14.3% (1/7 cases). Late survival longer than a year was obtained in five cases (71%). The longest patient survival time was nine years. No tissue degeneration was noted.
  
  
  CONCLUSIONS
  This technique may be useful for repairing a post-infarction VSD.
authors.affiliation: Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan. isodas@ndmc.ac.jp
authors.forename: Susumu
authors.initials: S
authors.lastname: Isoda
authors.forename: Motohiko
authors.initials: M
authors.lastname: Osako
authors.forename: Tamizo
authors.initials: T
authors.lastname: Kimura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mashiko
authors.forename: Nozomu
authors.initials: N
authors.lastname: Yamanaka
authors.forename: Shingo
authors.initials: S
authors.lastname: Nakamura
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Maehara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D004338:Drug Combinations; D005260:Female; D005557:Formaldehyde / Q000627:therapeutic use; D005780:Gelatin / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012118:Resorcinols / Q000627:therapeutic use; D013536:Suture Techniques; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D014463:Ultrasonography; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*
chemical_list: D004338:Drug Combinations; D012118:Resorcinols; D014014:Tissue Adhesives; C027813:gelatin-resorcinol-formaldehyde tissue adhesive; D005557:Formaldehyde; D005780:Gelatin