Double-patch technique for postinfarction ventricular septal perforation

Early and Late Results of Surgical Treatment for Ventricular Septal Rupture With and Without Use of the Infarction Exclusion Technique-Experience With Two- and Three-Sheet Modification

“…The three sheets consisted of two for the single patch and a third sheet for the additional patch. This additional patch concept is the same as the double‐patch technique reported by Tabuchi in 2004 1 …”

“…In this study, the mortality rate was significantly lower in the IE than in the non‐IE group. Although this procedure reduced the mortality rate from 61% to 21%, we encountered certain difficulties in determining the optimal patch size and shape for diminishing residual shunting 1,7 . Therefore, we modified the original procedure to a two‐sheet single‐patch technique, in which two separate sheets, sewed to the septum and free wall, are sewn at the center to create a single asymmetrical three‐dimensional endoventricular patch fitting the geometry of the left ventricular cavity.…”

“…Application of this technique resulted in significantly reduced pulmonary/systemic blood flow as compared with that obtained using the original infarction exclusion technique. They also used biological glue 1,7 . However, we were hesitant to use biological glue, in view of reports that some glue formulations may release toxic products and alter the histological structure of vessel walls 8 .…”

“…Ventricular septal rupture (VSR) is a relatively infrequent, but life threatening, complication of acute myocardial infarction (AMI). Although outcomes have improved since the introduction of the infarction exclusion technique, surgical repair of postinfarction VSR continues to be associated with high mortality rates, ranging from 19% to 40% 1 . We began using the infarct exclusion technique in 1995 for patients with acute VSR.…”

A Modified Infarct Exclusion Repair of Posterior Postinfarction Ventricular Perforation: Triple-patch Technique for Postinfarction Ventricular Septal Perforation in 2 Female Patients

“…Subsequently, some modifications of the infarction exclusion method have been devised to prevent postoperative residual shunting. [8][9][10] Since 2003, we have also modified the classic David-Komeda infarction exclusion technique exclusion technique using three equine pericardial patches to prevent these postoperative problems.…”