Early surgical outcomes of a modified infarct exclusion technique in acute post-myocardial infarction ventricular septal rupture : a single-centre experience
© Indian Association of Cardiovascular-Thoracic Surgeons 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law..
Introduction: Operative mortality in an acute post-myocardial infarction (AMI) ventricular septal rupture (VSR) is high. In addition to ventricular dysfunction, friable myocardium adds to the technical difficulty of the operation. In a modified infarct exclusion technique, the right ventricle is left undisturbed and the free edge of the pericardial patch is incorporated in the sutures while closing the left ventriculotomy. This simplifies the procedure and decreases the chances of right ventricular dysfunction, any residual defect, and bleeding.
Methods:.
Study design: A retrospective analysis of patients with VSR following AMI operated in our institute from January 2018 to June 2021 was done.
Results: Over the last 3 years, 16 patients with AMI VSR were treated with a modified infarct exclusion technique. Eight patients presented in cardiogenic shock preoperatively and were put on intra-aortic balloon pump support. All patients could be weaned successfully from the cardiopulmonary bypass, no patient had any residual defect, and none of the patients required re-exploration for bleeding. Postoperatively, 5 patients died within the first week and 2 more patients subsequently died due to intractable arrhythmias over the next 30 days.
Conclusions: In our centre, the mortality following repair of VSR after AMI was 43%. The modified infarct exclusion technique is a good technique with less chances of postoperative re-exploration and residual defect.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
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| Enthalten in: |
Indian journal of thoracic and cardiovascular surgery - 39(2023), 3 vom: 01. Mai, Seite 251-257 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Aggarwal, Pankaj [VerfasserIn] |
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| Anmerkungen: |
Date Revised 02.05.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1007/s12055-023-01479-7 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356279723 |
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| 520 | |a © Indian Association of Cardiovascular-Thoracic Surgeons 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. | ||
| 520 | |a Introduction: Operative mortality in an acute post-myocardial infarction (AMI) ventricular septal rupture (VSR) is high. In addition to ventricular dysfunction, friable myocardium adds to the technical difficulty of the operation. In a modified infarct exclusion technique, the right ventricle is left undisturbed and the free edge of the pericardial patch is incorporated in the sutures while closing the left ventriculotomy. This simplifies the procedure and decreases the chances of right ventricular dysfunction, any residual defect, and bleeding | ||
| 520 | |a Methods: | ||
| 520 | |a Study design: A retrospective analysis of patients with VSR following AMI operated in our institute from January 2018 to June 2021 was done | ||
| 520 | |a Results: Over the last 3 years, 16 patients with AMI VSR were treated with a modified infarct exclusion technique. Eight patients presented in cardiogenic shock preoperatively and were put on intra-aortic balloon pump support. All patients could be weaned successfully from the cardiopulmonary bypass, no patient had any residual defect, and none of the patients required re-exploration for bleeding. Postoperatively, 5 patients died within the first week and 2 more patients subsequently died due to intractable arrhythmias over the next 30 days | ||
| 520 | |a Conclusions: In our centre, the mortality following repair of VSR after AMI was 43%. The modified infarct exclusion technique is a good technique with less chances of postoperative re-exploration and residual defect | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Infarct exclusion | |
| 650 | 4 | |a Modified | |
| 650 | 4 | |a Septal rupture | |
| 700 | 1 | |a Mahajan, Sachin |e verfasserin |4 aut | |
| 700 | 1 | |a Halder, Vikram |e verfasserin |4 aut | |
| 700 | 1 | |a Bansal, Vidur |e verfasserin |4 aut | |
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