title: Management of recurrent leaks following postinfarction ventricular septal defect repairs.
abstract: Ventricular septal rupture (VSR) complicates acute myocardial infarction (AMI) in less than 0.2% of cases and is usually surgically managed by endocardial patch repair with infarct exclusion. Although successful in 80% of cases, failure of patch repair (often because of patch dehiscence) results in attempts at percutaneous closure as reoperative mortality can be as high as 40%. We describe a case of an AMI in a 63-year-old male with resultant VSR that required repeat surgical patch repair secondary to recurrent leak. We discuss the management of recurrent leaks and surgical techniques aimed at decreasing residual defects.
authors.affiliation: Division of Cardiovascular Medicine, University of Louisville of School of Medicine, Louisville, Kentucky 40202, USA.
authors.forename: Sameh
authors.initials: S
authors.lastname: Sayfo
authors.forename: Lindsay O
authors.initials: LO
authors.lastname: Stepp
authors.forename: Brian
authors.initials: B
authors.lastname: Ganzel
authors.forename: Mark S
authors.initials: MS
authors.lastname: Slaughter
authors.forename: Michael P
authors.initials: MP
authors.lastname: Flaherty
mesh_terms: D057868:Anastomotic Leak / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal / Q000379:methods; D005500:Follow-Up Studies; D006342:Heart Rupture, Post-Infarction / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D035583:Rare Diseases; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging* / Q000601:surgery*