Matsuno Yutaro, Ikenaga Shigeru
Department of Cardiovascular Surgery, Tokuyama Central Hospital, Shunan, Japan.
Kyobu Geka. 2021 Oct;74(11):954-958.
We report a case in which infarct exclusion technique was used to repair residual shunt after extended sandwich patch technique for postinfarction ventricular septal perforation (VSP). A 76-yearold woman was diagnosed with postinfarction VSP and underwent extended sandwich patch technique through right ventriculotomy on the third day after the onset of VSP. No residual shunt was then observed by intraoperative transesophageal echocardiography, but a slight residual shunt was observed on the 7th day after operation. She had no symptom of cardiac failure, and was followed up. However, the residual shunt worsened, and she developed cardiac failure on the 48th day after the initial operation. An additional operation by infarct exclusion technique was performed. No residual shunt was observed after the additional operation. She has been doing well with no signs of cardiac failure.
我们报告了一例在采用延长三明治补片技术修复心肌梗死后室间隔穿孔（VSP）后残余分流时使用梗死灶封堵技术的病例。一名76岁女性被诊断为心肌梗死后VSP，并在VSP发作后第三天通过右心室切开术接受了延长三明治补片技术。术中经食管超声心动图未观察到残余分流，但术后第7天观察到轻微残余分流。她没有心力衰竭症状，并接受了随访。然而，残余分流加重，她在初次手术后第48天出现心力衰竭。遂进行了梗死灶封堵技术的再次手术。再次手术后未观察到残余分流。她目前情况良好，没有心力衰竭的迹象。
