Cargando…

A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture

BACKGROUND: The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett’s original technique of multi-patch repair...

Descripción completa

Detalles Bibliográficos
Autores principales: Katsumata, Takahiro, Daimon, Masahiro, Konishi, Hayato, Fukuhara, Shinji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871608/
https://www.ncbi.nlm.nih.gov/pubmed/29589211
http://dx.doi.org/10.1186/s40792-018-0426-3
_version_ 1783309662077059072
author Katsumata, Takahiro
Daimon, Masahiro
Konishi, Hayato
Fukuhara, Shinji
author_facet Katsumata, Takahiro
Daimon, Masahiro
Konishi, Hayato
Fukuhara, Shinji
author_sort Katsumata, Takahiro
collection PubMed
description BACKGROUND: The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett’s original technique of multi-patch repair of ruptured posterior septum. CASE PRESENTATION: The technique was employed in the operation of a 67-year-old male who presented with severe heart failure at the 10th day after he developed inferior myocardial infarction. His ventricular septum had ruptured at the level between the posteromedial papillary muscle and the mitral annulus. A large endoventricular patch covered separately over the locally patched septal defect and the ventriculotomy defect which was going to be roofed eventually with an external patch. Both defects were then individually closed in double layers, holding a single continuous patch in common. The common use of a single patch expedited multilayered closure of the left ventricular defects and could minimize geometric remodeling of the covered area. The patches on both the endocardial and the epicardial sides avoided potentially fatal bleeding from the ventriculotomy site. The transmural mattress sutures incorporating ventriculotomy patches required minimal bites toward the posteromedial papillary muscle and mitral annulus, thereby preserving the mitral valve function. CONCLUSIONS: Thus, the technique enhances the advantage of the left ventriculotomy in the repair of posterior septal rupture and avoids ventriculotomy-related morbidity.
format Online
Article
Text
id pubmed-5871608
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-58716082018-03-30 A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture Katsumata, Takahiro Daimon, Masahiro Konishi, Hayato Fukuhara, Shinji Surg Case Rep Case Report BACKGROUND: The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett’s original technique of multi-patch repair of ruptured posterior septum. CASE PRESENTATION: The technique was employed in the operation of a 67-year-old male who presented with severe heart failure at the 10th day after he developed inferior myocardial infarction. His ventricular septum had ruptured at the level between the posteromedial papillary muscle and the mitral annulus. A large endoventricular patch covered separately over the locally patched septal defect and the ventriculotomy defect which was going to be roofed eventually with an external patch. Both defects were then individually closed in double layers, holding a single continuous patch in common. The common use of a single patch expedited multilayered closure of the left ventricular defects and could minimize geometric remodeling of the covered area. The patches on both the endocardial and the epicardial sides avoided potentially fatal bleeding from the ventriculotomy site. The transmural mattress sutures incorporating ventriculotomy patches required minimal bites toward the posteromedial papillary muscle and mitral annulus, thereby preserving the mitral valve function. CONCLUSIONS: Thus, the technique enhances the advantage of the left ventriculotomy in the repair of posterior septal rupture and avoids ventriculotomy-related morbidity. Springer Berlin Heidelberg 2018-03-27 /pmc/articles/PMC5871608/ /pubmed/29589211 http://dx.doi.org/10.1186/s40792-018-0426-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Katsumata, Takahiro
Daimon, Masahiro
Konishi, Hayato
Fukuhara, Shinji
A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture
title A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture
title_full A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture
title_fullStr A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture
title_full_unstemmed A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture
title_short A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture
title_sort modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871608/
https://www.ncbi.nlm.nih.gov/pubmed/29589211
http://dx.doi.org/10.1186/s40792-018-0426-3
work_keys_str_mv AT katsumatatakahiro amodifiedmultipatchtechniquefordoublelayeredrepairofischemicposteriorventricularseptalrupture
AT daimonmasahiro amodifiedmultipatchtechniquefordoublelayeredrepairofischemicposteriorventricularseptalrupture
AT konishihayato amodifiedmultipatchtechniquefordoublelayeredrepairofischemicposteriorventricularseptalrupture
AT fukuharashinji amodifiedmultipatchtechniquefordoublelayeredrepairofischemicposteriorventricularseptalrupture
AT katsumatatakahiro modifiedmultipatchtechniquefordoublelayeredrepairofischemicposteriorventricularseptalrupture
AT daimonmasahiro modifiedmultipatchtechniquefordoublelayeredrepairofischemicposteriorventricularseptalrupture
AT konishihayato modifiedmultipatchtechniquefordoublelayeredrepairofischemicposteriorventricularseptalrupture
AT fukuharashinji modifiedmultipatchtechniquefordoublelayeredrepairofischemicposteriorventricularseptalrupture