Sato Hiroki, Suzuki Nobuaki, Baba Toshio, Ueda Tetsuyuki, Mawatari Tohru, Izumiyama Osamu, Morishita Kiyofumi, Hasegawa Tadashi
Department of Cardiovascular and Thoracic Surgery, Hakodate Municipal Hospital, Hakodate, Japan.
Ann Thorac Cardiovasc Surg. 2008 Jun;14(3):192-5.
We report a case of repair of the postinfarction ventricular septal perforation (VSP), using an equine pericardium tailored in an asymmetrical conical shape for exclusion (modified sack technique) and an additional direct patch closure of VSP. An asymmetrical conical patch is easily sutured to the normal septum away from the VSP edge by using the longer part of the cone border. The postoperative left ventriculogram 1.5 months after surgery revealed a minor leakage from the patch to the excluded left ventricle. However, no residual left to the right shunt was found in calculation from the oxygen saturation in blood samples. Echocardiography 1 year after surgery showed no residual patch leakage at all. We suggest that this modified sack technique is a simple and easy method by which to exclude the VSP.
我们报告了一例心肌梗死后室间隔穿孔（VSP）的修复病例，采用定制为不对称圆锥形用于封堵的马心包（改良袋状技术）以及额外直接修补VSP。通过使用圆锥边缘较长的部分，不对称圆锥形补片很容易缝合到远离VSP边缘的正常间隔上。术后1.5个月的左心室造影显示补片处有少量漏血至被封堵的左心室。然而，根据血样中的氧饱和度计算，未发现残余左向右分流。术后1年的超声心动图显示补片完全没有残余漏血。我们认为这种改良袋状技术是一种简单易行的排除VSP的方法。
