Surgery of postinfarction ventricular septal rupture: The effect of David infarct exclusion versus Daggett direct septal closure on early and late outcomes

Abstract

David infarct exclusion was superior to Daggett direct septal closure for early and late survival after surgery for postinfarction ventricular septal rupture. Total coronary revascularization improved survival more in the David than in the Daggett group.

Early and midterm outcomes of triple patch technique for postinfarction ventricular septal defects

“…It was reported that 30-day mortality rates and residual shunt rates range from 34.5% to 40.7% and from 22.8% to 37.6%, respectively, after VSD repair of postinfarction VSD. [2][3][4][5] In our study, 30-day mortality was 23.8% and residual shunt rate was 14.3%. Therefore, our study showed that modified infarct exclusion triple patch technique was not inferior to David infarct exclusion repair or Daggett direct septal closure technique.…”

“…4 The widespread availability of venoarterial extracorporeal membrane oxygenation and other temporary circulatory support devices allows for perioperative support of these patients and potentially for patient optimization and surgery at a delayed stage, and may result in improved survival. 5,6 The technical aspects associated with VSD repair have remained challenging. From the early description of Cooley and colleagues 7 to the most recent report in this issue of the Journal, 8 many techniques have been described to address the frailty of the tissues and prevent recurrent or residual VSD.…”

Left Ventricular Pseudo-aneurysm with Ventricular Septal Rupture Due to Anterior ST-segment Elevation Myocardial Infarction

“…In the present case, concomitant CABG during surgical repair for perforation was not performed because the clinical benefit for the infarcted myocardium was not clear. Furthermore, the culprit artery was close to the left ventriculotomy and could be damaged during infarctectomy or entrapped in the closure suture line (3). Most studies have shown that revascularization has no benefit on early or late survival (3).…”

Modified double patch repair with infarct exclusion technique for ventricular septal perforation: a case study

“…Arnaoutakis et al reported on the largest and most recent database of The Society of Thoracic Surgeons in 2012 [ 1 ]; operative mortality was found to be 54.1% if repair was attempted within 7 days of AMI. On the other hand, Lundblad et al reported that the 30-day mortality rate of VSP closure using the infarct exclusion technique was 16.7%, which was significantly better than that of patch closure [ 2 ]. Caimmi et al reported that the 30-day mortality rate of VSP closure using the double patch technique was 18.8%, and it showed good results when no postoperative residual shunt was observed [ 3 ].…”