Korean Circ J.  2016 Jan;46(1):107-110. 10.4070/kcj.2016.46.1.107.

Transatrial Approach for the Repair of the Posterior Post-Infarct Ventricular Septal Rupture

• Cho SH
• Kim WS

• KMID: 2223777
• DOI: http://doi.org/10.4070/kcj.2016.46.1.107

Abstract

Ventricular septal rupture (VSR) is a disastrous mechanical complication of myocardial infarction. Although several surgical interventions have been developed, mortality due to surgical management remains high, especially in the case of posterior VSR. We report a successful case of repair of posterior VSR using an alternative transatrial approach to avoid the complications related to ventricular incision.

Keyword

Myocardial infarction; Ventricular septal rupture

MeSH Terms

Mortality
Myocardial Infarction
Ventricular Septal Rupture*

Figure

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  Fig. 1 Coronary angiogram. Left anterior oblique cranial view shows near total occlusion at the middle right coronary artery.

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  Fig. 2 Transthoracic echocardiogram (TTE). A preoperative TTE reveals shunt flow through the ventricular septal rupture. RV: right ventricle, LV: left ventricle.

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  Fig. 3 Operative findings. Identification of the posterior postinfarction VSD through right atrium and tricuspid valvectomy. CS: coronary sinus, IVC: inferior vena cava, SVC: superior vena cava, PL: posterior leaflet, RAA: right atrial appendage, RV: right ventricle, SL: septal leaflet, VSD: ventricular septal defect.

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  Fig. 4 Schematic view after repair. Schematic view of ventricular septal rupture after patch closure and tricuspid valve replacement. PA: pulmonary artery, TV: tricuspid valve, VSD: ventricular septal defect, IVC: inferior vena cava, SVC: superior vena cava.

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