Early repair of postinfarction ventricular septal defect with gelatin-resorcin-formol biological glue

Ann Thorac Surg. 1996 Aug;62(2):486-8.

Abstract

Background: Early surgical repair of postinfarction ventricular septal defect has improved early mortality rate. Mortality remains high in patients presenting within 1 week of infarction, or when rupture has occurred in the inferior part of the septum.

Methods: We describe a surgical technique for repair of postinfarction ventricular septal defect that involves no infarctectomy: continuous suturing of a bovine pericardial patch to healthy myocardium around the infarcted area and use of gelatin-resorcin-formol biological glue as a sealant between the patch and the interventricular septum.

Results: We have used this technique successfully in 3 consecutive patients in whom repair was performed within 1 week of myocardial infarction. The rupture of the interventricular septum was located anteriorly in 2 patients and inferiorly in the other. They all made an uneventful recovery, and at follow-up there was no evidence of residual shunt.

Conclusions: This technique can be a useful adjunct to the surgical management of this difficult group of patients.

MeSH terms

  • Aged
  • Animals
  • Cardiomyopathies / pathology
  • Cardiomyopathies / surgery
  • Cardiopulmonary Bypass
  • Cattle
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Formaldehyde / therapeutic use*
  • Gelatin / therapeutic use*
  • Heart Rupture, Post-Infarction / pathology
  • Heart Rupture, Post-Infarction / surgery*
  • Heart Septum / pathology
  • Heart Septum / surgery*
  • Heart Ventricles / pathology
  • Heart Ventricles / surgery
  • Humans
  • Intra-Aortic Balloon Pumping
  • Male
  • Myocardial Infarction / surgery
  • Pericardium / transplantation
  • Resorcinols / therapeutic use*
  • Survival Rate
  • Suture Techniques
  • Tissue Adhesives / therapeutic use*
  • Transplantation, Heterologous

Substances

  • Drug Combinations
  • Resorcinols
  • Tissue Adhesives
  • gelatin-resorcinol-formaldehyde tissue adhesive
  • Formaldehyde
  • Gelatin