A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture
Abstract Background The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett’s original technique of multi-patc...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-03-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-018-0426-3 |
| _version_ | 1818856485514379264 |
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| author | Takahiro Katsumata Masahiro Daimon Hayato Konishi Shinji Fukuhara |
| author_facet | Takahiro Katsumata Masahiro Daimon Hayato Konishi Shinji Fukuhara |
| author_sort | Takahiro Katsumata |
| collection | DOAJ |
| description | Abstract Background The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett’s original technique of multi-patch repair of ruptured posterior septum. Case presentation The technique was employed in the operation of a 67-year-old male who presented with severe heart failure at the 10th day after he developed inferior myocardial infarction. His ventricular septum had ruptured at the level between the posteromedial papillary muscle and the mitral annulus. A large endoventricular patch covered separately over the locally patched septal defect and the ventriculotomy defect which was going to be roofed eventually with an external patch. Both defects were then individually closed in double layers, holding a single continuous patch in common. The common use of a single patch expedited multilayered closure of the left ventricular defects and could minimize geometric remodeling of the covered area. The patches on both the endocardial and the epicardial sides avoided potentially fatal bleeding from the ventriculotomy site. The transmural mattress sutures incorporating ventriculotomy patches required minimal bites toward the posteromedial papillary muscle and mitral annulus, thereby preserving the mitral valve function. Conclusions Thus, the technique enhances the advantage of the left ventriculotomy in the repair of posterior septal rupture and avoids ventriculotomy-related morbidity. |
| first_indexed | 2024-12-19T08:25:15Z |
| format | Article |
| id | doaj.art-809594f5cd864397a1108c0ddfef4991 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-19T08:25:15Z |
| publishDate | 2018-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-809594f5cd864397a1108c0ddfef49912022-12-21T20:29:18ZengSpringerOpenSurgical Case Reports2198-77932018-03-01411510.1186/s40792-018-0426-3A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal ruptureTakahiro Katsumata0Masahiro Daimon1Hayato Konishi2Shinji Fukuhara3Department of Thoracic and Cardiovascular Surgery, Osaka Medical CollegeDepartment of Thoracic and Cardiovascular Surgery, Osaka Medical CollegeDepartment of Thoracic and Cardiovascular Surgery, Osaka Medical CollegeDepartment of Thoracic and Cardiovascular Surgery, Osaka Medical CollegeAbstract Background The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett’s original technique of multi-patch repair of ruptured posterior septum. Case presentation The technique was employed in the operation of a 67-year-old male who presented with severe heart failure at the 10th day after he developed inferior myocardial infarction. His ventricular septum had ruptured at the level between the posteromedial papillary muscle and the mitral annulus. A large endoventricular patch covered separately over the locally patched septal defect and the ventriculotomy defect which was going to be roofed eventually with an external patch. Both defects were then individually closed in double layers, holding a single continuous patch in common. The common use of a single patch expedited multilayered closure of the left ventricular defects and could minimize geometric remodeling of the covered area. The patches on both the endocardial and the epicardial sides avoided potentially fatal bleeding from the ventriculotomy site. The transmural mattress sutures incorporating ventriculotomy patches required minimal bites toward the posteromedial papillary muscle and mitral annulus, thereby preserving the mitral valve function. Conclusions Thus, the technique enhances the advantage of the left ventriculotomy in the repair of posterior septal rupture and avoids ventriculotomy-related morbidity.http://link.springer.com/article/10.1186/s40792-018-0426-3Ventricular septal ruptureMyocardial infarctionRepair |
| spellingShingle | Takahiro Katsumata Masahiro Daimon Hayato Konishi Shinji Fukuhara A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture Surgical Case Reports Ventricular septal rupture Myocardial infarction Repair |
| title | A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture |
| title_full | A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture |
| title_fullStr | A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture |
| title_full_unstemmed | A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture |
| title_short | A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture |
| title_sort | modified multi patch technique for double layered repair of ischemic posterior ventricular septal rupture |
| topic | Ventricular septal rupture Myocardial infarction Repair |
| url | http://link.springer.com/article/10.1186/s40792-018-0426-3 |
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