ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT VÁ THỦNG VÁCH LIÊN THẤT SAU NHỒI MÁU CƠ TIM

Abstract

Introduction: Ventricular septal perforation is a serious and uncommon complication of acute myocardial infarction. Patients without surgical treatment have a high mortality rate. There are many types of surgery to treat this disease, including two-patch technique through the right ventriculotomy. The research aims to evaluate the results of surgery for the treatment of ventricular septal perforation after myocardial infarction by the two-patch technique. Methods: This is a retrospective case series of repairing ventricular septal perforation by the two-patch technique through the right ventriculotomy at Cho Ray Hospital from January 2014 to January 2020. Results: From January 2014 to January 2020, we used the two-patch method to repair the ventricular septum perforation for 36 patients. The mean age of the patients was 67.2 ± 11.4 years. There are 28 male patients (77.8%). Mean aortic clamping time was 97.4 minutes. Mean cardiopulmonary bypass time was 146.2 minutes. Early mortality rate is 22.2%; there were 3 cases of postoperative stroke, 4 cases of bleeding requiring re-operation, 5 cases of renal failure requiring hemodialysis. For the mid-term result, there was death from recurrent myocardial infarction. Conclusions: Ventricular septal perforation surgery after myocardial infarction with the two-patch technique is safe, effective and has good mid-term results. The technique has the advantage of simplicity, less likely to have recurrent of the ventricular septum defect and can be applied to both anterior and posterior ventricular septal perforation.