Two-patch technique for postinfarction inferoposterior ventricular septal defect.

We describe 4 patients with postinfarction inferoposterior ventricular septal defect treated by the two-patch technique for infarct exclusion operation. The ventricular septal defects were closed using two bovine pericardial patches as follows. The septal patch was sutured to the noninfarcted septum covering the defect, and the free wall patch was sutured to the endocardium adjacent to the posterior papillary muscle. The two patches were sutured together and all infarcted areas were excluded from the left ventricular pressure. This technique seems to be useful in specific circumstances, such as when the ventricular defect is located in the inferoposterior septum.