How to anastomose a patch to avoid residual leak in the infarct exclusion method. Issue 3 (30th January 2020)

• Record Type: Journal Article
• Authors: Kitamura, Hideki; Koyama, Yutaka; Tamaki, Mototsugu; Sawada, Koshi; Kawaguchi, Yasuhiko
• Is Part Of: Journal of cardiac surgery. Volume 35:Issue 3(2020)
• Page Start: 659
• Page End: 661
• Publication Date: 2020-01-30
• Subjects: infarct exclusion method -- postinfarction ventricular septal defect -- residual leak; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.14442
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Background and Aim: Postinfarction ventricular septal defect is a potentially lethal complication of acute myocardial infarction for which surgical repair is mandatory. The infarct exclusion method has contributed to improving surgical outcomes, but a certain percentage of residual leakage continues to be reported. We considered possible mechanisms of residual leakage and modified the sewing method to overcome these mechanisms. Method: A bovine pericardial patch and a Teflon felt strip between the patch and endocardium to achieve good fit were used. The patch and felt were anchored with U stay sutures and reinforced with a running suture. Results: Use of the modified method in seven cases showed improved outcomes. Only one patient had trivial leakage, compared to nine cases using the older method; six of nine patients had residual leaks, including three minor ones. Conclusions: Our method is a rational approach that effectively reduces residual leakage.