Avrupa Şafak Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul

Background: There are different approaches for surgical treatment of postinfarction ventricular septal rupture (PVSR). We prefer to take our patients to the operation immediately and choose the most appropriate operative technique during the operation according to the extent of infarction and the site of rupture. In this retrospective study we sought short-term results of our approach in surgical treatment of PVSR. Methods: Seven patients (4 males, 3 females; mean age 60 years; range 41 to 70 years) underwent repair of PVSR in our clinic between February 2001 and April 2005. Mean time interval between myocardial infarction and surgical treatment was 7.2±2.4 days in six cases. One patient was operated eight months after myocardial infarction. Locations of septal ruptures were anterior (n=2), posterior (n=1), apical (n=2) and midseptal (n=2). The following surgical repair techniques were performed: plication in two patients, infarction excision technique in one patient, a modified infarct exclusion technique in two patients and apical amputation and closure with teflon pledgeted interrupted sutures in two patients. Concomitant coronary artery bypass grafting was performed in three patients. Results: All the patients were transferred to the intensive care unit with inotropic support and intraaortic balloon pump was used in 4 cases. One patient (14.3%) died. Mean intensive care unit stay was 4.6 (2-9) days. Mean duration of hospital stay was 11.4 (6-29) days. There was no residual shunt. Conclusions: For the repair of PVSR, successfull results can be gained, with respect to mortality and residual shunt, by performing surgical intervention during acute phase with choice of a patient-based surgical technique.