Posterior ventricular septal rupture: An anatomical reconstruction

S. B. Pett, F. Follis, K. Allen, T. Temes, J. A. Wernly

Research output: Contribution to journalArticlepeer-review


Rupture of the ventricular septum following posterior myocardial infarction is an uncommon, but lethal, injury that requires prompt repair. Surgical reconstruction can be complex, demanding, and unfamiliar. Conventional techniques, as described in the literature, are associated with a variety of potential pitfalls. An alternative method we have successfully used in our last four patients is presented in detail. The procedure uses two composite (felt/pericardium) patches: an internal patch to reconstruct the left ventricular geometry and an external patch to repair the subtotal infarctectomy. For maximal security, all suture lines sandwich myocardium between two continuous felt surfaces. Specific transition stitches are described, which reliably anchor the entire repair at the critical, but poorly visualized, areas where the ventricular septum makes its transition to left and right ventricular free walls. This technique offers immediate hemostasis and a more anatomical left ventricular geometry. The method also reduces the risk of systemic thromboembolism, residual VSD, and repair disruption.

Original languageEnglish
Pages (from-to)445-450
Number of pages6
JournalJournal of Cardiac Surgery
Issue number6
Publication statusPublished - 1998

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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