Editorial comments on patch size and mechanics in the surgery for post-infarction ventricular septal perforation.

Finite element analysis method (FEM) provides suitable methodology to analyze a target with complex shape such as VSP patch. In this study, by employing the FEM, Ito and colleagues showed the importance of using a large patch to eliminate the dead space between the patch and LV endocardium. Intuitionally many surgeons believed the same way, but it now has been proven mathematically. Although the FEM model has some limitation in part due to too much simplified model, I believe that the study provides useful information to the patch mechanics for VSP closure and that it will help improving the outcome of surgical treatment of VSP.