Objects: The outcome of post-myocardial infarction ventricular septum perforationVSPstill remains poor even in the era of established cardiovascular surgery. Although we had repaired VSP by modified David-Komeda method since 2002, we changed to Sandwich Technique via Right Ventricle in 2009 because of significant residual shunt. We compared Sandwich technique via Right Ventricle with David-Komeda method. Patients and Methods: Between 2002 and 2016, 30 consecutive patients with post-infarction VSP who underwent surgical repair at our institutes were retrospectively reviewed. We compared 15 patients who repaired by Sandwich TechniqueS groupwith 12 patients by David-Komeda methodDK group. Sandwich Technique: After incision into the right ventricle, control of LV venting under beating enables the surgeon to visualize the region. The hard Teflon felt patch is covered with the bovine pericardium not only for the LV side but for the RV side, as well. One places on the left ventricular side and the other on the right ventricular side. Eight interrupted 4- 0 polypropylene mattress sutures are applied to the edge of the VSP. Results: There were no significant differences in clinical preoperative and intraoperative characteristics of patients between two groups. Although 30 days-mortality was not significantly different, a year-alive rate in S group had a higher tendency. The rates of re-operation and residual shunt were significantly higher in DK group. Conclusions: RV incision provides easy bleeding control and the sandwich technique provides geometric preservation of the left ventricular shape and prevents residual shunt.

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