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Eur J Cardiothorac Surg 2002;21:725-732
© 2002 Elsevier Science NL
a Department of Cardio-Vascular Surgery, Hopital Haut-Lévêque, Avenue de Magellan, 33604 Bordeaux-Pessac, France
b Hopital d'Instruction des Armées Robert Picqué, 33140 Villenave d'Ornon, France
c Department of Intensive Care of Cardiology, Bordeaux Heart University Hospital, 33604 Bordeaux-Pessac, France
Received 20 September 2001; received in revised form 3 January 2002; accepted 16 January 2002.
* Corresponding author. Tel.: +33-5-5655-6437; fax: +33-5-5615-8157
e-mail: louis.labrousse{at}chu-bordeaux.fr
Objective: Repair of post infarction ventricular septal defect (VSD) is still a challenging procedure with a high risk of recurrence of the VSD and subsequent mortality. The aim of this retrospective study was to assess if technical change in the surgical procedure was followed by an improvement in recurrence of the VSD and operative results. Method: This retrospective study from 1971 to 2001 included 85 patients operated on early (<15 days) after the occurrence of a post infarction VSD. Double patch technique was introduced in 1986. A total of 44 variables were studied by a uni- and multivariate analysis. Results: Hospital death occurred in 36 patients. Significant factors for hospital mortality included: preoperative and evolution of the clinical status, right ventricular function and type of repair (one or two patches). Moreover, no recurrence was observed in patients repaired with the double patch technique (P=0.09). None of the studied variables were significant for long term survival. Concomitant CABG was not associated with higher hospital mortality and long-term survival rate was similar in patients with or without concomitant CABG. Conclusion: The use of the double patch technique and glue by avoiding recurrence of the VSD played a role in the reduction of the hospital mortality. This technique has to be recommended in the early repair of post infarction VSD. Concomitant CABG can be done safely to control the added risk of an associated coronary artery lesion.
Key Words: Myocardial infarction • Ventricular septal defect • Coronary disease • Cardiac surgery
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