Journal of cardiac surgery · 2015
"Sandwich Technique" via a Right Ventricle Incision to Repair Postinfarction Ventricular Septal Defects.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Isoda Susumu, Imoto Kiyotaka, Uchida Keiji, Nishimura Kenji, Karube Norihisa, Suzuki Shinichi, Masuda Munetaka
Аннотация
BACKGROUND: Residual shunting and mortality are problems associated with the current surgical repair techniques for postinfarction ventricular septal defects (VSD). We developed the "sandwich technique" via a right ventricle incision and assessed the surgical outcome of 13 years of experience with this technique.
METHODS: Between June 2001 and March 2013, 25 consecutive patients with postinfarction VSD underwent surgical repair using this technique. This technique includes the following: Application of direct ultrasonography to the right ventricular (RV) wall enables the surgeon to visualize the lesion, perform an appropriate incision into the RV, and perform a trabecular resection. One patch is placed on the left ventricular (LV) side and the other on the RV side of the VSD. The VSD is sealed with gelatin-resorcin-formalin (GRF) glue between the two patches.
RESULTS: Thirty-day mortality was 0% (0/25 case). A postoperative major shunt occurred in three patients (12%, 3/25) and two of them required reoperation (8%, 2/25). Hospital mortality was 28% (seven patients). Mean follow-up period was 4.2 ± 3.7 years. The overall survival at one, five, and 10 years was 71 ± 9%, 65 ± 10%, and 56 ± 12%, respectively. There was no cardiac death during follow-up in the patients who survived for six months after the surgery. No tissue degeneration related to GRF glue was noted.
CONCLUSION: The "sandwich technique" via a right ventricle incision results in a low incidence of postoperative leak and good short- and mid-term survival.
METHODS: Between June 2001 and March 2013, 25 consecutive patients with postinfarction VSD underwent surgical repair using this technique. This technique includes the following: Application of direct ultrasonography to the right ventricular (RV) wall enables the surgeon to visualize the lesion, perform an appropriate incision into the RV, and perform a trabecular resection. One patch is placed on the left ventricular (LV) side and the other on the RV side of the VSD. The VSD is sealed with gelatin-resorcin-formalin (GRF) glue between the two patches.
RESULTS: Thirty-day mortality was 0% (0/25 case). A postoperative major shunt occurred in three patients (12%, 3/25) and two of them required reoperation (8%, 2/25). Hospital mortality was 28% (seven patients). Mean follow-up period was 4.2 ± 3.7 years. The overall survival at one, five, and 10 years was 71 ± 9%, 65 ± 10%, and 56 ± 12%, respectively. There was no cardiac death during follow-up in the patients who survived for six months after the surgery. No tissue degeneration related to GRF glue was noted.
CONCLUSION: The "sandwich technique" via a right ventricle incision results in a low incidence of postoperative leak and good short- and mid-term survival.