The right atrial approach for repairing a posterior ventricular septal rupture may provide better visualization and preserve postoperative ventricular function by avoiding a ventricular incision.
Supports right atrial approach for posterior VSR; hypothesis-generating for visualization and function benefits, needing comparative trials.
BACKGROUND: Ventricular septal rupture (VSR) is a life-threatening complication following acute transmural myocardial infarction. Posteriorly located ruptures are one of the main predictors of poor prognoses because of the surgical difficulties associated with this location. CASE PRESENTATION: A 72-year-old man with a posterior VSR underwent surgical repair via the right atrial approach. The patient's postoperative course was uneventful, and echocardiography showed no residual shunt flow. He was discharged on postoperative day 37. CONCLUSION: By temporally detaching the tricuspid valve leaflet, this approach provides a better view and handling space within the posterior ventricular septum than the trans-ventricular approach. Additionally, avoiding a ventricular incision can better preserve postoperative ventricular function.
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Kitabayashi et al. (2016) studied this question.
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