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Surgical treatment for complications of acute myocardial infarction

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The Japanese Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objective: We report the results of surgical repair for postinfarction left ventricular free wall rupture (LVFR) and ventricular septal perforation (VSP) complicating acute myocardial infarction. Methods: We experienced 14 LVFRs and 10 VSPs from January 1991 to December 2002. The mean age of patients with LVFR was 74±8.1 years. There were 6 oozing cardiac ruptures and 8 blowout cardiac ruptures. An intraaortic balloon pump (IABP) was inserted in 8 patients, and percutaneous cardiopulmonary support (PCPS) was inserted in 5 patients. The mean age of patients with VSP was 72±5.1 years. The rupture was located within the anterior septum in 8 patients and within the posterior septum in 2 patients. All patients required IABP, and one of them needed PCPS. We employed a sutureless technique in 8 patients, direct closure in 5 patients, and infarct exclusion in 1 patient with LVFR. Infarct exclusion was conducted in 9 patients, and the da Silva technique was used in 1 patient with VSP. Results: The patient survival rate of LVFR was 36% (blowout 13%; oozing 67%). Residual shunt occurred in 4 patients with VSP postoperatively. The overall survival rate for VSP was 70%. Conclusion: The operative prognosis of blowout cardiac rupture was poor. Good results were obtained with the infarct exclusion technique for patients with VSP. Although some patients had postoperative residual shunts, the infarct exclusion technique was generally a safe and excellent procedure.

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References

  1. Hatcher CR Jr, Mansour K, Logan WD Jr, Symbas PN, Abbott OA. Surgical complications of myocardial infarction. Am Surg 1970; 36: 163–70.

    PubMed  Google Scholar 

  2. Yamada T, Yamaguchi T, Takaki M, Kugimiya T. A case of successful surgical treatment for LV free wall blow-out rupture after acute myocardial infarction. Jpn J Cardiovasc Surg 1999; 28: 181–4.

    Google Scholar 

  3. Masai T, Sakakibara T, Watanabe S, Kodama K, Kaneko M, Matsuda H. A case report of successful surgical treatment following the emergency circulatory assist by percutaneous cardiopulmonary support system for acute postinfarction left ventricular free wall rupture (Eng abstr). Nippon Kyobu Geka Gakkai Zasshi 1992; 40: 86–90.

    PubMed  CAS  Google Scholar 

  4. Daggett WM, Guyton RA, Mundth ED, Buckley MJ, McEnany MT, Gold HK, et al. Surgery for post-myocardial infarct ventricular septal defect. Ann Surg 1977; 186: 260–71.

    Article  PubMed  CAS  Google Scholar 

  5. Komeda M, Fremes SE, David TE. Surgical repair of postinfarction ventricular septal defect. Circulation 1990; 82 (Suppl IV): IV-243–7.

    CAS  Google Scholar 

  6. Padro JM, Mesa JM, Silvestre J, Larrea JL, Caralps JM, Cerron F, et al. Subacute cardiac rupture: Repair with a sutureless technique. Ann Thorac Surg 1993; 55: 20–4.

    Article  PubMed  CAS  Google Scholar 

  7. da Silva JP, Cascudo MM, Baumgratz JF, Vila JHA, Macruz R. Postinfarction ventricular septal defect: An efficacious technique for early surgical repair. J Thorac Cardiovasc Surg 1989; 97: 86–9.

    PubMed  Google Scholar 

  8. Shozawa T, Masuda H, Sageshima M, Kawamura K, Okada E, Saito N. Classification of cardiac rupture complicated in myocardial infarction. Pathological study of 32 cases. Acta Pathol Jpn 1987; 37: 871–86.

    PubMed  CAS  Google Scholar 

  9. Nunez L, del la Llana R, Lopez Sendon J, Coma I, Gil Aguado M, Larrea JL. Diagnosis and treatment of subacute free wall ventricular rupture after infarction. Ann Thorac Surg 1983; 35: 525–9.

    Article  PubMed  CAS  Google Scholar 

  10. Iben AB, Pupello DF, Stinson EB, Shumway NE. Surgical treatment of postinfarction ventricular septal defects. Ann Thorac Surg 1969; 8: 252–62.

    Article  PubMed  CAS  Google Scholar 

  11. Shibata T, Suehiro S, Ishikawa T, Hattori K, Kinoshita H. Repair of postinfarction ventricular septal defect with joined endocardial patches. Ann Thorac Surg 1997; 63: 1165–7.

    Article  PubMed  CAS  Google Scholar 

  12. Matsuda K, Oda T, Terai H, Hanyu M, Ban T. New surgical technique for repair of ventricular septal perforation. Ann Thorac Surg 1995; 60: 1430–1.

    Article  PubMed  CAS  Google Scholar 

  13. Muehrcke DD, Daggett WM Jr, Buckley MJ, Akins CW, Hilgenberg AD, Austen WG. Postinfarct ventricular septal defect repair: Effect of coronary artery bypass grafting. Ann Thorac Surg 1992; 54: 876–83.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. First Department of Surgery, Yamaguchi University School of Medicine, Yamaguchi, Japan

    Kimikazu Hamano MD

  2. Division of Cardiovascular Surgery, Shakaihoken Tokuyama Central Hospital, 1-1 Kodacho, Shunan, 745-0822, Yamaguchi, Japan

    Haruhiko Okada MD, Masahiko Nishida MD & Masanori Murakami MD

Authors
  1. Haruhiko Okada MD
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  2. Masahiko Nishida MD
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  3. Masanori Murakami MD
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  4. Kimikazu Hamano MD
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Okada, H., Nishida, M., Murakami, M. et al. Surgical treatment for complications of acute myocardial infarction. Jpn J Thorac Caridovasc Surg 53, 74–77 (2005). https://doi.org/10.1007/s11748-005-0004-z

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  • DOI: https://doi.org/10.1007/s11748-005-0004-z

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