title: Right atrial approach for repairing a posterior ventricular septal rupture: a case report.
abstract: BACKGROUND
  Ventricular septal rupture (VSR) is a life-threatening complication following acute transmural myocardial infarction. Posteriorly located ruptures are one of the main predictors of poor prognoses because of the surgical difficulties associated with this location.
  
  
  METHODS
  A 72-year-old man with a posterior VSR underwent surgical repair via the right atrial approach. The patient's postoperative course was uneventful, and echocardiography showed no residual shunt flow. He was discharged on postoperative day 37.
  
  
  CONCLUSIONS
  By temporally detaching the tricuspid valve leaflet, this approach provides a better view and handling space within the posterior ventricular septum than the trans-ventricular approach. Additionally, avoiding a ventricular incision can better preserve postoperative ventricular function.
authors: Department of Cardiovascular Surgery, Kinan Hospital, Shinjo-cho 46-70, Tanabe, 646-8588, Wakayama, Japan. k-kitabayashi@hotmail.co.jp.
authors: Katsukiyo
authors: http://orcid.org/0000-0001-5085-4555
authors: K
authors: Kitabayashi
authors: Department of Cardiovascular Surgery, Kinan Hospital, Shinjo-cho 46-70, Tanabe, 646-8588, Wakayama, Japan.
authors: Keisuke
authors: K
authors: Miyake
authors: Department of Cardiovascular Surgery, Kinan Hospital, Shinjo-cho 46-70, Tanabe, 646-8588, Wakayama, Japan.
authors: Nobuo
authors: N
authors: Sakagoshi
keywords: Acute myocardial infarction; Mechanical complication; Posterior ventricular septal rupture; Right atrial approach