Use of a patch technique to repair post myocardial infarction ventricular septal defect

Repair of post myocardial infarction ventricular septal defect is complex due to impaired bi-ventricular function, heart failure, cardiogenic shock, poor anatomic delineation of septal defect and poor quality myocardial tissue. We describe a technique that places a patch with pledgets on the right ventricular aspect of the defect. Appropriate resection of anterior wall of left ventricle is done. A large bovine pericardial patch is used to reinforce the ventriculotomy with sutures taken from inside the left ventricle from the relatively healthy area of the endocardium, marking the junction of infarcted and non-infarcted areas. The current technique may also facilitate the remodelling of the left ventricle