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心肌梗死后室间隔破裂的扩大三明治补片修复中的堤状技术

Embankment technique in extended sandwich patch repair for post-infarction ventricular septal rupture.

作者信息

Nishigawa Kosaku, Tateishi Retsu, Ono Shunya, Kanemura Takeyuki

机构信息

Department of Cardiovascular Surgery, IMS Katsushika Heart Center, 3-30-1 Horikiri, Katsushika, Tokyo, 124-0006, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2025 May;73(5):372-374. doi: 10.1007/s11748-025-02125-2. Epub 2025 Feb 2.

Abstract

Extended sandwich patch repair for post-infarction ventricular septal rupture is a surgical technique that closes the defect using two patches, with one on the right ventricular side and the other on the left ventricular side. In this technique, filling materials such as surgical glue are often used between the two patches. We routinely use BioGlue surgical adhesive as a filler. However, there are concerns regarding residual shunts because of incomplete closure of the defect and the risk of embolism caused by the glue leaking into the left ventricle. Therefore, we have developed a technique to create a "bank" using an absorbable hemostatic agent between the patch and the defect, aiming to secure defect sealing and prevent embolism caused by the glue. We have named this procedure the "embankment technique." In 11 consecutive cases treated with this procedure, no residual shunts or embolic events were observed.

摘要

心肌梗死后室间隔破裂的扩大三明治补片修复术是一种外科技术,使用两片补片封闭缺损,一片置于右心室侧,另一片置于左心室侧。在该技术中,两片补片之间常使用外科胶水等填充材料。我们常规使用BioGlue外科粘合剂作为填充物。然而,由于缺损闭合不完全存在残余分流的担忧,以及胶水漏入左心室导致栓塞的风险。因此,我们开发了一种技术,在补片与缺损之间使用可吸收止血剂形成一个“堤岸”,旨在确保缺损封闭并防止胶水引起的栓塞。我们将此手术命名为“堤岸技术”。在连续11例接受该手术治疗的病例中,未观察到残余分流或栓塞事件。

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