A 54 year male was admitted with acute inferior wall MI . He had history ... read more ↘ of chest pain about a week back .He was in gross pulmonary oedema on admission and was found to have inferior wall MI with posterior VSD and moderate MR .He was stabilised on IABP, and was found to have DVD . He was taken for CABG with posterior VSD repair. Intraoperative TEE showed posterior VSD with moderate MR.On ventriculotomy he had 1.5x 1.5 cm posterior VSD.This was repaired with double patch inner patch 2 x 2 cm Dacron sutured with three 4-0 proline sutures from RV to LV( teflon strip on RV side) at 12 3 and 9 o clock . This was reinforced with bovine pericardial patch with continuous 4-0 proline. the ventriculotomy was closed with 2-0 Ticron interrupted sutures on teflon strip either side of ventriculotomy . The diagonal was bypassed with LIMA .On intraoperative TEE there was no residual shunt and mild MR . ↖ read less
