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Ann Thorac Surg 2010;89:2049-2052. doi:10.1016/j.athoracsur.2009.08.013
© 2010 The Society of Thoracic Surgeons
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Ryo Suzuki
Bungo Shirasawa
Kimikazu Hamano
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Right arrow Myocardial infarction

How To Do It

Simple Geometrical Infarct Exclusion Technique With a Single Patch for Postinfarction Ventricular Septal Perforation

Toshiro Kobayashi, MD, Akihito Mikamo, MD, Ryo Suzuki, MD, Masanori Murakami, MD, Bungo Shirasawa, MD, Kimikazu Hamano, MD*

Department of Surgery and Clinical Science, Division of Cardiac Surgery, Yamaguchi University, Graduate School of Medicine, Yamaguchi, Japan

Accepted for publication August 7, 2009.

* Address correspondence to Dr Hamano, Department of Surgery and Clinical Science, Division of Cardiac Surgery, Yamaguchi University, Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan (Email: kimikazu{at}yamaguchi-u.ac.jp).

Six consecutive patients underwent emergency surgical repair of a postinfarction ventricular septal perforation. The principle of this technique is a simple three-dimensional repair with a nontailored square patch beforehand, which provides an adequate-sized pouch and prevents dehiscence of the patch being caused by excessive tension on the suture line. It also prevents a residual shunt. A single equine pericardium was sutured to the viable muscle circumferentially around the infarcted area to be excluded, after which the free edge of the patch was tailored and sutured in a pouch configuration. This technique seems to provide satisfactory early results in the acute phase of myocardial infarction.






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