A new sutureless “double‐patch frame”technique for early repair of Postinfarction Ventricular Rupture without ventriculotomies

P0113 

Abstract Submission 

Liang Tao (1), Laichun Song (2), Xiao Wang (3)

(1) Wuhan Asia heart Hospital, Wuhan, Hubei, (2) Wuhan Asia Heart Hospital, Wuhan, Hubei, (3) Nanjing Drum Tower Hospital, Jiangsu

Liang Tao    -  Contact Me
Wuhan Asia heart Hospital

Laichun Song    -  Contact Me
Wuhan Asia Heart Hospital

Xiao Wang    -  Contact Me
Nanjing Drum Tower Hospital

Liang Tao    -  Contact Me
Wuhan Asia heart Hospital

Objective: Ventricular septal rupture (VSR) is a severe complication of acute myocardial infarction, and the conventional technique for repair is associated with high operative mortality. A novel sutureless "double‐patch frame" technique was used as a less invasive treatment for VSR; it does not postpone the timing of surgery, require left or right ventricular incision and suturing in the fragile ventricular wall.
Methods: Four patients underwent successful correction and recovery uneventful. total cardiopulmonary bypass was established via a median sternotomy. A "double‐patch frame" was produced with a trimmed Dacron patch and expandable spongeare just as the data from cardiac CTA and TEE. A low transverse aortotomy and right atriotomy were performed to implant the "double‐patch frame" to correct VSR without suturing. TEE was used to evaluate the residual VSP shunting, biventricular function, and the left ventricular outflow tract.
Results: All procedures were completed safely and effective. The averaged VSR left-to-right shunt before the procedure was 1.55cm (ranged from 1.2cm to 1.8cm). The CPB and aorta clamping time were 139.7min (125-155 mins) and 75min (67-89 mins), respectively. The left-to-right shunt disappeared in one patient after the procedure, and trial residual VSR left-to-right shunt in another three patients without hemodynamic disorder. Hemodynamic instability improved dramatically after the procedure. All the patients had an uneventful postoperative course and discharged successfully. During the following-up, TTE showed the jet is unchanged and all the patients have no symptoms and self-supportive at home
Conclusions: This new sutureless "double‐patch frame" technique was simple and significantly decreased the left-to-right shunt. The technique was able to control the heart failure associated with VSR without ventriculotomies during the procedure. Potential improvements in VSR treatment outcomes are expected with its clinical application.

Coronary Artery Disease