Okamoto Yuki, Yamamoto Kazuo, Yoshii Shinpei
Department of Cardiovascular Surgery, Tachikawa Medical Center, Nagaoka, Japan.
Ann Cardiothorac Surg. 2022 May;11(3):273-280. doi: 10.21037/acs-2021-ami-13.
Postinfarction ventricular septal rupture (VSR) remains an important and life-threatening complication of myocardial infarction (MI). Although several techniques have improved surgical outcomes of postinfarction VSR, the treatment is still challenging with a high mortality rate. In addition, it is well known that a postoperative residual shunt after VSR repair is associated with poor outcomes; however, late outcomes involving patients with a residual shunt after VSR repair are lacking. This paper presents the early and late outcomes of patients who underwent the triple patch technique to repair a VSR and the usefulness in reducing a postoperative residual shunt. The main process of this technique is that the patch is gently placed on the myocardium with over and over suture and is firmly attached using glue. Therefore, the triple patch technique is simple and easy to perform, and is designed to minimize residual shunt and exclude infarcted myocardium. In the present keynote lecture, we describe our surgical technique and the results of VSR repair.
心肌梗死后室间隔破裂（VSR）仍然是心肌梗死（MI）的一种重要且危及生命的并发症。尽管多种技术已改善了心肌梗死后VSR的手术效果，但该治疗仍具有挑战性，死亡率很高。此外，众所周知，VSR修复术后的残余分流与不良预后相关；然而，缺乏关于VSR修复术后存在残余分流患者的远期预后情况。本文介绍了接受三重补片技术修复VSR患者的早期和远期预后，以及该技术在减少术后残余分流方面的有效性。该技术的主要过程是将补片轻轻置于心肌上，反复缝合，并使用胶水牢固固定。因此，三重补片技术操作简单，旨在最大程度减少残余分流并排除梗死心肌。在本次主题演讲中，我们描述了我们的手术技术及VSR修复的结果。
