Moorjani N, Viola N, Haw M. Postinfarction inferior ventricular septal rupture: surgical repair through the right atrium.
J Card Surg 2009;
24:218-20. [PMID:
19267836 DOI:
10.1111/j.1540-8191.2009.00826.x]
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Abstract
Operative mortality of inferior postinfarct ventricular septal rupture (VSR) remains high. Previous reports have described a transatrial approach to access the VSR avoiding a ventriculotomy, thereby reducing the potential risks of myocardial damage, hemorrhage, and ventricular arrhythmias. The transatrial right ventricular patch or direct suture repair, however, is exposed to the left-to-right pressure gradient and is at risk of residual shunting. In this report, a transatrial approach is used, with direct suture of the VSR, patch exclusion of the right ventricle, and biological glue instillation to protect the patch from left ventricular pressures.
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