- •The right ventricular incision is close and parallel to the infarct-culprit artery.
- •A large LV-patch, introduced via the VSR, gives wide-enough coverage.
- •The patches are fixed with large transeptal/transmural mattress sutures.
- •All sutures are a safe distance (1.5-2 cm) from the debrided defect edge.
- •BioGlue is inserted in the defect space only after the LV patch is secured.
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Financial disclosures: The authors declare no conflicts of interest associated with this manuscript.
An extended sandwich patch, placed via right ventriculotomy, with transseptal/transmural mattress sutures safely distant from the defect, minimizes risks of shunt recurrence after VSR repair.