Surgical Management of a Residual Shunt after Extended Sandwich Repair via a Right Ventricular Incision for Posterior Ventricular Septal Perforation
- VernacularTitle:後壁心室中隔穿孔修復術後遺残短絡の急性増悪をきたし再修復術を要した1例
- Author:
Tomohito KANZAKI
1
;
Tomoyuki GOTO
1
;
Taiji WATANABE
1
;
Haruka FU
1
Author Information
- Keywords: acute myocardial infarction; posterior ventricular septal perforation; residual shunt; right ventricular incision; extended sandwich technique
- From:Japanese Journal of Cardiovascular Surgery 2021;50(5):309-313
- CountryJapan
- Language:Japanese
- Abstract: Posterior ventricular septal perforation (VSP) is a severe complication of acute myocardial infarction (AMI). In some cases, it is difficult to manage residual shunts after VSP repair. We report a patient who required reoperation early after surgery due to a residual shunt and underwent successful repair through a newly devised maneuver. A 55-year-old man developed VSP after catheter intervention for AMI. He underwent VSP closure with extended sandwich repair via a right ventricular (RV) incision. A residual shunt was observed on the 4th day after surgery. Follow-up echocardiography showed progress of the residual shunt, and he developed cardiac failure ; therefore, reoperation was performed 16 days after the initial surgery. The residual shunt was successfully repaired with only a reinforcing left ventricular (LV) side patch via an LV incision to extend between the LV side patch and septal myocardium without removing the RV side patch. The patient's clinical course after reoperation was uneventful, and no residual shunt was observed on postoperative echocardiography.
