Long Term Outcome of Ventricular Septal Perforation after Post-infaction^|^mdash;The Efficiency of Double-Patch Repair with a Bilateral Ventriculotomy^|^mdash;

Objectives: Repair of a postinfarction ventricular septal perforation (VSP) had been a difficult procedure with a high risk of postoperative residual shunt and subsequent mortality. This retrospective study aimed to assess a modified infarct exclusion technique with a biventricular approach. Methods: Thirty three consecutive patients who underwent the infarct exclusion procedure for VSP between 2002 and 2013 were reviewed. A biventricular approach (B group: 9 patients) and a left ventricular approach (L group: 24 patients) were analyzed. Results: The overall 30-day mortality of B and L group was 11%, and 21%, respectively, and there was not different between the two groups (p=0.53). No postoperative residual shunt was observed in the B group, however 8 cases in the L group (p=0.034). The overall five-year survival rate in the B and L group was 89% and 61%, respectively (p=0.19), however, the survival rate at five years revealed that significant difference between with and without residual VSP. Conclusion: The repair of post-infarction VSP can be safely performed by the infarct exclusion technique with a biventricular approach. This technique contributed to reduce surgical mortality and prevented recurrence of the VSP.