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Postinfarction Inferior Ventricular Septal Rupture: Surgical Repair Through the Right Atrium
Author(s) -
Moorjani Narain,
Viola Nicola,
Haw Marcus
Publication year - 2009
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2009.00826.x
Subject(s) - ventriculotomy , medicine , ventricle , cardiology , shunting , fibrous joint , surgery
Operative mortality of inferior postinfarct ventricular septal rupture (VSR) remains high. Previous reports have described a transatrial approach to access the VSR avoiding a ventriculotomy, thereby reducing the potential risks of myocardial damage, hemorrhage, and ventricular arrhythmias. The transatrial right ventricular patch or direct suture repair, however, is exposed to the left‐to‐right pressure gradient and is at risk of residual shunting. In this report, a transatrial approach is used, with direct suture of the VSR, patch exclusion of the right ventricle, and biological glue instillation to protect the patch from left ventricular pressures.