Postinfarction posterior ventricular septal defect repair: Infarct exclusion technique

2021 ◽  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Median Sternotomy ◽  
Drug Eluting Stent ◽  
Chronic Obstructive ◽  
Inferior Wall ◽  
Obstructive Pulmonary Disease ◽  
Bovine Pericardial Patch ◽  
Infarct Exclusion ◽  
The Right

A 61-year-old man, an active smoker with associated chronic obstructive pulmonary disease on bronchodilator therapy, presented with acute inferior ST-elevation myocardial infarction. The right coronary artery was shown to be the infarct-related artery and was ultimately treated with a drug-eluting stent with an optimal angiographic result. Despite treatment, the patient continued to experience chest pain. Echocardiography showed an extensive posterior mid-ventricular septal defect. Given the scenario of an acute ventricular septal defect with impending hemodynamic repercussions, emergency surgery was pursued. After a median sternotomy and institution of cardiopulmonary bypass with bicaval cannulation, the inferior wall was exposed to assess the necrotic scar. After ventriculotomy, there was an irregular large septal defect with poorly defined margins. In this case, the posterior papillary muscle showed patchy areas of necrosis, requiring a mitral valve replacement. The ventricular septal defect was repaired using an oval-shaped bovine pericardial patch sutured with 3-0 polypropylene sutures, secured with Teflon pledgets, placed transmurally in healthy endocardium. The same patch was incorporated in the ventriculotomy closure.

Repair of Morgagni hernia and ventricular septal defect through sternotomy

2018 ◽  
Vol 26 (2) ◽  
pp. 158-160
Author(s):  
Hesham Alkady ◽  
Mohammad Fawzy Abbas ◽  
Mahmoud Zayed ◽  
Talha Elsayed
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Median Sternotomy ◽  
Male Infant ◽  
Anterior Mediastinum ◽  
Diaphragmatic Defect ◽  
Morgagni Hernia ◽  
Hernia Sac ◽  
Perimembranous Ventricular Septal Defect ◽  
The Right

We report a case of Morgagni hernia occupying the anterior mediastinum and right hemithorax in a male infant with Down syndrome, who also had a perimembranous ventricular septal defect. Through a median sternotomy, the hernia sac was freed from the right pleura, and the pericardium was opened to reduce its contents (colon) into the abdomen. The diaphragmatic defect was closed with Prolene mesh and the hernia sac was used to reinforce the diaphragmatic defect. Finally, the pericardium was opened and the ventricular septal defect was closed with a polytetrafluoroethylene patch through a right atriotomy after instituting cardiopulmonary bypass.

CONDITION OF HEMODYNAMICS IN THE PULMONARY CIRCULATION OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) CONCURRENT WITH METABOLIC SYNDROME WITH HYPERTROPHY AND ATROPHY OF THE MYOCARDIUM

2019 ◽  
Vol 72 (8) ◽  
pp. 1491-1493
Author(s):  
Viktor P. Boriak ◽  
Svitlana V. Shut’ ◽  
Tetiana A. Trybrat ◽  
Olena V. Filatova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Metabolic Syndrome ◽  
Right Ventricular ◽  
Pulmonary Disease ◽  
Pulmonary Circulation ◽  
Contractile Function ◽  
Ventricular Myocardium ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Right

Introduction: In recent years, COPD is observed as not an isolated, but an associated pathology, in particular, concurrent with metabolic syndrome. The aim of the research is to identify the differences in changes of the rheopulmonography parameters (RPG) depending on the presence of hypertrophy or atrophy of the right ventricular myocardium in patients with COPD concurrent with metabolic syndrome.. Materials and methods: We studied changes in rheopulmonography (RPG) in 145 patients with chronic obstructive pulmonary disease (COPD) concurrent with metabolic syndrome. Results: We detected precapillary hypertension of the pulmonary circulation in patients with right ventricular myocardial hypertrophy: anacrotism serration; flattened peak of the systolic wave; decreased Vcp; high placement of incisura; horizontal course of catacrotism; decreased amplitude of the systolic wave (in this case, due to a greater increase in the resistance of the blood flow in the pulmonary vessels than the decreased impact volume of the right ventricle); prolonged Q-a (in this group of patients, it depends more on hypertension of the pulmonary circulation than on the reduction of contractile function of the myocardium). In atrophy of the right ventricular myocardium, the following changes in the RPG were revealed: decreased systolic wave at its dramatic rise; prolonged Q-a (in this case, due to the weakened heart contraction); Vmax reduction (it reflects the reduction of myocardial contractility); in hypertrophy of the myocardium, Vcp., unlike RPG, does not decrease, which is explained by the decrease in the pressure of the pulmonary circulation. Conclusions: We believe that these changes in RPG allow differentiating hypertrophy and right ventricular myocardial atrophy along with established diagnostic criteria, and can be used as markers for the diagnosis and treatment of COPD concurrent with metabolic syndrome.

The state of the cardiovascular system in occupational bronchitis and chronic obstructive pulmonary disease, not associated with the impact of harmful industrial factors

2021 ◽  
pp. 55-68
Author(s):  
Vyacheslav S. Lotkov ◽  
Anton Vladimirovich Glazistov ◽  
Antonina G. Baykova ◽  
Marina Yuryevna Vostroknutova ◽  
Natalia E. Lavrentieva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular System ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Occupational Lung Diseases ◽  
The Right ◽  
The Impact

The formation and progression of chronic dust bronchitis and chronic bronchitis of toxic-chemical etiology, chronic obstructive pulmonary disease is accompanied by an increase in the degree of ventilation disorders, echocardiographic signs of hypertrophy and dilatation of the right ventricle are formed, typical for chronic pulmonary heart disease. The progression of disturbances in the function of external respiration in dusty lung diseases leads to a decrease in myocardial contractility. The detection of hemodynamic disturbances at the early stages of the development of occupational lung diseases indicates the need for individual monitoring of the functional state of the cardiovascular system in the process of contact with industrial aerosols, especially in groups of workers with long-term exposure.

Postinfarction posterobasal ventricular septal defect closure with a triple-layer patch

2021 ◽  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Great Part ◽  
Cardiac Apex ◽  
Ventricular Septal Defect Closure ◽  
Dacron Patch ◽  
Basal Septum ◽  
The Right ◽  
Infarcted Tissue ◽  
Anterior Septum

We present the case of a 65-year-old patient who developed a large posterobasal ventricular septal defect resulting from an extensive acute myocardial infarction involving the inferior and basal septum and wall. We repaired the interventricular lesion by verticalizing the cardiac apex to perform a left posterobasal ventriculotomy. We removed a great part of the residual infarcted tissue, leaving the residual scar in place. Our technique first involved creating a double-layer patch comprising heterologous pericardium and a non-collagen-impregnated Sauvage Dacron patch, fixed with single pledgeted U-stitches from the right side of the anterior septum; then we applied a third layer of heterologous pericardium on the left side of the septum in order to have only a pericardial surface in contact with blood on both ventricular sides. A running suture was used to complete the procedure from the middle to the posterior rim of the ventricular septal defect.

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