title: Double-patch repair by a bilateral ventriculotomy for postinfarction ventricular septal defect.
abstract: OBJECTIVE
  Repair of a postinfarction ventricular septal defect (VSD) is a challenging procedure with a high risk of postoperative residual shunt and subsequent mortality. This retrospective study aimed to assess a modified infarct exclusion technique with a biventricular approach.
  
  
  METHODS
  Nineteen consecutive patients who underwent the infarct exclusion procedure for VSD between 2002 and 2011 were reviewed. A biventricular approach (B group: 6 patients) and a left ventricular approach (L group: 13 patients) were studied by univariate analysis.
  
  
  RESULTS
  The overall 30-day mortality was 15.8%, and was not different between the two groups (p=0.94). Postoperative residual shunt was not observed in the B group (p=0.21). The overall five-year survival rate was 79%, and there were no late deaths in the B group (p=0.14).
  
  
  CONCLUSIONS
  The repair of postinfarction VSD can be safely performed by the infarct exclusion technique with a biventricular approach. This technique seems to reduce surgical mortality and prevents recurrence of the VSD.
authors.affiliation: Department of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji, Japan.
authors.forename: Ryuma
authors.initials: R
authors.lastname: Iwaki
authors.forename: Keitaro
authors.initials: K
authors.lastname: Nakagiri
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Murakami
authors.forename: Naoto
authors.initials: N
authors.lastname: Morimoto
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshida
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Mukohara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012189:Retrospective Studies; D055502:Secondary Prevention; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome