Ischemic VSD Repair With Transapical Mitral Valve Replacement
The development of ischemic ventricular septal rupture is an uncommon but frequently fatal complication. Mortality with medical treatment only is extremely high. Septal rupture results in a left-to-right shunt, with right ventricular volume overload, increased pulmonary blood flow, and secondary volume overload of the left atrium and ventricle. In some cases, this condition is accompanied by a concomitant mitral valve regurgitation in need of surgical therapy. This poses a challenge as to the management strategy and the surgical access. We present a treatment concept consisting of a transapical closure of the ventricular septal defect and a simultaneous replacement of the mitral valve through the same access. Furthermore, this technique allows the anchoring of a pericardial patch in healthy myocardial tissue.
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