Abstract
Three surgical cases of acute ventricular septal perforation (VSP) successfully repaired with flat and conic patches are reported. The first case was a 58-year-old man who had undergone a double patch closure with two flat patches for VSP following acute myocardial infarction. On the third postoperative day, however, a redo operation became necessary due to recurrent VSP, and in this surgery flat and conic patches were used. The second and third cases were 82-year-old and 81-year-old women, respectively, who from the first underwent VSP closures with flat and conic patches. Although in the third case the patient died of hypoxic ischemic encephalopathy 2 months after operation, the others recovered well and were discharged at 2 months. Our procedure consists of an infarct exclusion technique and a double patch technique. The flat patch is for directly covering the infracted ventricular septum including the VSP through a left ventriculotomy. The conic patch is for three-dimensionally lining the infracted endocardium of the left ventricle. Similar procedures applying the same concept have been reported as effective for repairing acute VSP. The combination of both an infarct exclusion technique and a double patch technique can be thought of as an ideal strategy and our procedure provides one such option.
