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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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CASE REPORTS  CARDIAC SECTION


The Journal of Cardiovascular Surgery 2002 August;43(4):465-6

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Repair of a postinfarct ventricular septal defect on the beating heart. Surgical considerations

Reber D., Tosson R., Khargi K., Laczkovics A.

Department of Cardiothoracic Surgery, Ruhr-University Bochum, Bochum, Germany


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Postinfarct ven­tric­u­lar sep­tal ­defect (VSD) ­still ­remains asso­ciat­ed ­with a ­high mor­tal­ity and mor­bid­ity. Despite the devel­op­ment of ­modern sur­gi­cal tech­niques and med­i­cal ­care it con­tin­ues to be a dif­fi­cult ther­a­peu­tic chal­lenge. This ­report ­describes a ­case of a 70-­year-old ­female ­patient, who pre­sent­ed ­with a post­in­farct VSD ­after hav­ing ante­ri­or ­wall infarc­tion. She pre­sent­ed ­with ­left ­heart fail­ure, pul­mo­nary hyper­ten­sion and ­left to ­right ­shunt of 78% (Qp/Qs=4.3). The ­patient was oper­at­ed on ­using car­di­o­pul­mo­nary ­bypass on the beat­ing ­heart. The clo­sure was per­formed ­with a Dacron-­patch and a sin­gle ­bypass to the diag­o­nal ­branch ­using the ­left inter­nal tho­rac­ic ­artery. Postoperatively the ­patient did ­well and was dis­charged in ­good con­di­tion on the 13th post­op­er­a­tive day. We con­clude ­that post­in­farc­tion VSD can be ­repaired on car­di­o­pul­mo­nary ­bypass avoid­ing ­cross-clamp­ing. This meth­od is help­ful for the out­come as ­well as for the ear­ly post­op­er­a­tive recov­ery of eld­er­ly ­patients.

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