Outcome of Postinfarction Ventricular Septal Defect Repair in the Era of Mechanical Circulatory Support

2020 ◽  
Author(s):  
A. Tulun ◽  
B. Panholzer ◽  
F. Schoeneich ◽  
J. Schoettler ◽  
T. Puehler ◽  
...  
2015 ◽  
Vol 156 (25) ◽  
pp. 1014-1019
Author(s):  
László Király ◽  
Csaba Tamás

Introduction: Outcome of arterial switch operation for transposition of the great arteries with/without ventricular septal defect is a service key-performance-indicator. Aim: The aim of the authors was to assess patient characteristics and parameters in the perioperative course. Method: In the setting of a newly-established, comprehensive tertiary-care center, primary complete repair was performed including associated anomalies, e.g. transverse arch repairs. Patients with d-transposition were grouped according to coexistence of ventricular septal defect. Results: 118 arterial switch operations were performed between 2007 and 2014 with 96.62% survival (114/118). Ventricular septal defect and repair of associated anomalies did not yield worse outcome. Left ventricular re-training with late presentation necessitated mechanical circulatory support for 4.5±1.5 days. Conclusions: D-transposition is suitable for standardization of clinical algorithm and surgical technique. Quality standards contribute to excellent outcomes, minimize complications, and serve as blueprint for other neonatal open-heart procedures. Availability of mechanical circulatory support is key for single-stage left ventricular re-training beyond the neonatal period. Orv. Hetil., 2015, 156(25), 1014–1019.


Author(s):  
Mitesh V. Badiwala

Postinfarction ventricular septal defect and ventricular pseudoaneurysm are rare complications of acute transmural myocardial infarction. Because they are rare, surgical experience with these conditions is limited but advancements in surgical technique have resulted in improved survival. The infarction exclusion technique for repair of postinfarction ventricular septal defect in particular has resulted in significant survival benefit. Concomitant coronary artery bypass grafting has been demonstrated to improve long-term survival in those patients undergoing ventricular septal defect repair.


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