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KMID : 0364019960290010032
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Korean Journal of Thoracic and Cardiovascular Surgery
1996 Volume.29 No. 1 p.32 ~ p.37
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Surgical analysis of the Postinfarction Ventricular Septal Defect
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조유원
이현우/김동관/이재원/송명근
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Abstract
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Between May 1991 and September 1995, 7 patients underwent surgical repair of ventricular septal defect(VSD) complicated with myocardial infarction in Asan Medical Center. The patients included two male and five female. The ages of patients were
ranged
from 54 years to 76 years with a mean of 65years. The sites of postinfarction ventricular septal defect were consist of anterior septal defect in 6 patients and anteroposterior septal defect in 1 patient. Preoperative 2D-echocardiography &
angiography
were performed in all patients in all patients in order to measure ventricular function and evaluate the extent of coronary artery disease. The operations were delayed till mean 24±12days after myocardial infarction. All patients underwent
infarctectomy and Teflon patch closures through the area of the left ventricle infarction or aneurysm in the anterior or apical aspect of postinfarction ventricular septal defect. The ventricular septal defect repaired simultaneously with
coronary
artery bypass graft in 3 patients, with ventricular aneurysmectomy in 5 patients, and with left ventricular thrombectomy in l patient. Patch fixation in the left side of interventricular septum by trans-septal interrupted pledget suture reduced
the
recurrence rate of VSD. There were 2 postoperative complications; One with pneumonia, l patient with the skin necrosis of left thigh. There was no early death. The 6 patients except for one emigrant were followed up postoperatively between 3 and
63
months(mean: 28 months), without any sequelae and late death. They are in New York Heart Association functional class I-II.
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KEYWORD
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