A right atrial approach in redo postinfarction ventricular septal defect

Despite improvements in surgical techniques, post-infarction ventricular se ptal defect remains a surgical challenge that is associated with significan t early and late mortality. Furthermore, the recurrence of the defect after primary correction occurs in similar to 10-25% of patients, and the operat ive risk increases because of a difficult dissection that is often complica ted by previous patent grafts. The repair of recurrent ventricular septal d efect has generally been performed by ventriculotomy in the infarcted zone. The authors propose an alternative approach that, when the rupture is post erior, allows its complete visualization, and avoids any further ventriculo tomy in an already impaired ventricle. (C) 1999 The International Society f or Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights re served.