Patch exclusion technique with Amplatzer septal occluder device for the treatment of postinfarction ventricular septal defect.

Abstract

Abstract Objective Postinfarction ventricular septal defects (VSDs) is one of the serious mechanical complications of acute myocardial infarction and it is associated with high mortality even with surgical repair. Combining surgical patch closure with an Amplatzer septal occluder device (ASOD) is a novel technique that has not been reported before. Deploying an ASOD under direct vision through a left ventriculotomy followed by exclusion patch repair is a novel and dependable surgical technique of a repair for patients with postinfarction VSD. Methods This is a case series of two patients with large inferior postinfarction VSDs who underwent open repair with an ASOD deployed under direct vision through a left ventriculotomy followed by surgical exclusion patch repair. Results There was no immediate intraoperative complication from the repair, no residual VSD, no in hospital mortality. One patient was taken back to the operative room for bleeding on the day of surgery. One patient was discharged to a rehab facility and the other was discharged home. Both patients continue to do well after hospital discharge without any residual VSD. Conclusions Coupling the patch exclusion technique with an Amplatzer septal occluder device for the treatment of post infarction ventricular septal defect is a novel technique with excellent short-term results, but the long-term outcomes of this approach remain unknown.