Cicekcioglu Ferit, Tutun Ufuk, Parlar Ali Ihsan, Yay Kerem, Guray Yesim, Katircioglu Salih Fehmi
Cardiovascular Surgery Clinic, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
J Card Surg. 2008 Sep-Oct;23(5):580-3. doi: 10.1111/j.1540-8191.2007.00543.x.
The incidence of residual opening after repair of postmyocardial infarction ventricular septal defect (VSD) was reported to be 10% to 25%. Redo surgery with remedial sternotomy is more complex than primary surgery and is consequently associated with higher mortality and morbidity due to the myocardial and patent coronary grafts injury during pericardial dissection.
A 59-year-old female patient had coronary artery bypass grafting and closure of post myocardial infarction ventricular septal defect with patch 10 months earlier in a different cardiac center. She was admitted to the hospital for severe congestive heart failure.
She was operated because of the residual opening after repair of post myocardial infarction ventricular septal defect. Post myocardial infarction ventricular septal defect closure was performed through the right atrium by on-pump beating heart technique via the right thoracotomy.
Closure of post myocardial infarction ventricular septal defect with this technique offers an alternative and safe approach to repair of the residual VSD when the coronary bypass grafts are patent.
据报道，心肌梗死后室间隔缺损（VSD）修复术后残余开口的发生率为10%至25%。再次开胸手术比初次手术更为复杂，因此由于心包剥离过程中心肌和冠状动脉搭桥移植血管损伤，其死亡率和发病率更高。
一名59岁女性患者10个月前在另一家心脏中心接受了冠状动脉搭桥术和心肌梗死后室间隔缺损补片修补术。她因严重充血性心力衰竭入院。
她因心肌梗死后室间隔缺损修补术后残余开口而接受手术。通过右胸壁切口，在体外循环心脏跳动下经右心房进行心肌梗死后室间隔缺损修补。
当冠状动脉搭桥移植血管通畅时，采用该技术闭合心肌梗死后室间隔缺损为修复残余室间隔缺损提供了一种安全的替代方法。
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