EARLY REPAIR OF POSTINFARCTION VENTRICULAR SEPTAL-DEFECT WITH GELATIN-RESORCINOL-FORMOL BIOLOGICAL GLUE

Background. Early surgical repair of postinfarction ventricular septal defect has improved early mortality rate. Mortality remains high in p atients presenting within 1 week of infarction, or when rupture has oc curred in the inferior part of the septum. Methods. We describe a surg ical technique for repair of postinfarction ventricular septal defect that involves no infarctectomy: continuous suturing of a bovine perica rdial patch to healthy myocardium around the infarcted area and use of gelatin-resorcin-formol biological glue as a sealant between the patc h and the interventricular septum. Results. We have used this techniqu e successfully in 3 consecutive patients in whom repair was performed within 1 week of myocardial infarction. The rupture of the interventri cular septum was located anteriorly in 2 patients and inferiorly in th e 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.