Repair of Postinfarction Ventricular Septal Defect: Posterior Inferior Ventricular Septal Defect

摘要

Blood supply to the ventricular septum arises from the septal perforating branches of the left anterior descending artery and the posterior descending artery. Acquired ventricular septal defects (VSDs) most often result from myocardial infarction (MI) due to complete occlusion of one of these vessels in the setting of single-vessel coronary artery disease. Thus, the protective effect of the collateral circulation that develops from progressive stenosis in the setting of multivessel disease is not present. In accordance with this principle, postinfarction VSDs usually occur after the patient's first MI, and most patients deny a history of angina. Posterior VSDs occur with occlusion of the posterior descending artery or in the case of a left-dominant coronary system, the circumflex coronary artery. They represent roughly one-fourth of postinfarction VSDs.