Early and midterm outcomes of triple patch technique for postinfarction ventricular septal defects

Objective: Early and midterm outcomes were evaluated in patients who had postinfarction ventricular septal defect (VSD) and underwent VSD repair using the triple patch technique. Methods: Twenty-one patients underwent VSD repair for postinfarction VSD between April 2004 and September 2015. A retrospective analysis of all in-hospital and postdischarge data was performed. In addition, we compared pre- and perioperative variables between survivors and nonsurvivors. Results: Thirty-day mortality was 23.8%(5 patients). Three patients died due to low output syndrome and 2 patients died due to sepsis. All of these patients were in cardiogenic shock preoperatively. Although 3 patients had a small residual shunt after surgery, the residual shunt disappeared 6 months after surgery in 1 patient and has been decreasing gradually in another. The mean follow-up was 43.5 +/- 36.1 months. Overall survival rates (Kaplan-Meier method) at 3 and 8 years were 70.8% and 57.9%, respectively. Compared with survivors, nonsurvivors had a higher incidence of preoperative cardiogenic shock, higher incidence of chronic kidney disease and end-organ failure, and longer aortic crossclamp times during surgery. Conclusions: Early and midterm outcomes of modified infarct exclusion using the triple patch technique are acceptable. This technique is safe and simple, and may be useful for reducing postoperative residual shunt.