Department of Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan.
Department of Cardiovascular Surgery, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, Hiroshima, Japan.
J Cardiothorac Surg. 2024 Apr 20;19(1):249. doi: 10.1186/s13019-024-02673-3.
Post-myocardial infarction (MI) ventricular septal perforation (VSP) is a rare but life-threatening complication. Surgical repair is challenging and carries significant risks, particularly in the context of recurrent VSPs. This case study presents a patient with recurrent VSP after initial surgical repair following myocardial infarction.
A 65-year-old male were re-administered to our hospital due to recurrent VSP. He was during follow up after undergone emergency VSP closure surgery 2 months earlier, utilizing the bovine double patch technique via left ventriculostomy. The initial VSP was located in the apical part of the interventricular septum, while the recurrent VSP appeared in the upper middle portion of the interventricular septum (Fig. 1). As the previous patch remained intact, the second surgery employed the bovine double patch technique via right ventriculostomy. The patient's condition remained stable without the development of heart failure symptoms.
Repairing recurrent VSPs remains a challenge, necessitating the mastery of appropriate approaches to achieve optimal outcomes. Further research and guidelines are required to refine management strategies for recurrent VSPs.
心肌梗死后室间隔穿孔（VSP）是一种罕见但危及生命的并发症。手术修复具有挑战性，且风险较大，特别是在 VSP 反复发作的情况下。本病例研究报告了 1 例心肌梗死后初次手术修复后反复发作 VSP 的患者。
一名 65 岁男性，因 VSP 反复发作再次入我院。他在 2 个月前因 VSP 行紧急 VSP 关闭手术，通过左心室造口术使用牛双补片技术。初次 VSP 位于室间隔心尖部，而再次 VSP 则出现在室间隔中上段（图 1）。由于先前的补片保持完整，第二次手术通过右心室造口术使用牛双补片技术。患者情况稳定，未出现心力衰竭症状。
修复反复发作的 VSP 仍然具有挑战性，需要掌握适当的方法以获得最佳结果。需要进一步研究和制定指南，以完善反复发作 VSP 的管理策略。
