Postinfarction ventricular septal rupture: repair by endocardial patch with XXXX exclusion.

@entity1 @entity3584 @entity1757 @entity260 @entity177 @entity1188 @entity1562 @entity1576 @entity583 @entity67 @entity1455 @entity291 @entity204 @entity1002
A novel operative technique for postinfarction @entity1757 has been used in 44 consecutive @entity1 . The operation consists of excluding rather than excising the infarcted septum and ventricular walls. This is accomplished by performance of a left ventriculotomy through the infarcted muscle and securing a @entity3584 -fixed @entity291 pericardium patch to the endocardium of the left ventricle all around the infarcted @entity1562 . The ventriculotomy is simply closed over the pericardial patch. There were 21 @entity1 and 23 @entity1 whose mean age was 69 +/- 7 years. Twenty-nine @entity1 were in @entity1455 at the time of operation. All @entity1 had Doppler echocardiography and coronary angiography before operation. All but two @entity1 were operated on during the acute phase of the @entity583 . There were six operative @entity204 . @entity260 included @entity177 in 10 @entity1 and @entity1576 in 18. Severe @entity67 was the only independent predictor of operative mortality. @entity1 have been followed up for a mean of 40 +/- 34 months. There have been six late @entity204 and three of these were because of cardiac problems. The actuarial survival at 6 years was 66% +/- 7%. Only one @entity1 had a small residual @entity1757 . Late postoperative assessment of ventricular function by echocardiography revealed that most @entity1 had normal or mild @entity67 and mild or moderate @entity1002 . Repair of acute postinfarction @entity1757 by endocardial patch with @entity1188 exclusion of the left ventricule probably avoids additional damage to the right ventricle, remodels the acutely infarcted left ventricle, and enhances survival.
