Abstract
Objective: Left ventricular free wall rupture after acute myocardial infarction is a serious complication with high mortality. For life-saving, it is important how to maintain poor hemodynamics till operation. We have consistently made it our strategy to attach percutaneous cardiopulmonary support system and intra-aortic balloon pumping immediately after the diagnosis regardless of the type of left ventricular free wall rupture and of the hemodynamic conditions, and perform an infarction-covering repair under the heating heart. We have studied the short-term and middle-term results after the operations, and have evaluated the efficacy and problems of this procedure.Methods: Since September 1994, we have performed this method in six of eight patients with left ventricular free wall rupture.Results: As results, five of the six patients (83%) were saved including two cases of blow-out type. Our strategy for left ventricular free wall rupture showed several advantages for preoperative and intraoperative maintenance of the hemodynamic conditions, and for preservation of some reversible myocardium by the simple technique of infarction-covering repair under the beating heart. These resulted in shortening the operation time, decreasing the incidence of low cardiac output syndrome, and obtaining a satisfactory rate of life-saving.Conclusion: We believe that this infarction-covering repair based on our strategy is effective for life-saving during the acute period.
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References
Biorck G, Mogensen L, Nyquist O, Orinius E, Sjogrenet A. Studies of myocardial rupture with cardiac tamponade in acute myocardial infarction. Chest 1972; 61: 4–6.
Van Tassel RA, Edward JE. Rupture of heart complicating myocardial infarction: analysis of 40 cases including nine examples of left ventricular false aneurysm. Chest 1972; 61: 104–16.
Shapira I, Isakov A, Burke M, Almog C. Cardiac rupture in patients with acute myocardial infarction. Chest 1987; 92: 219–23.
Nunez L, de la Liana R, Sendon JL, Coma I, Gil AM, Larrea JL. Diagnosis and treatment of subacute free wall vetricular rupture after infarction. Ann Thorac 1983; 35: 525–9.
Padro JM, Caralps JM, Montoya JD, Camara ML, Picart GJ, Aris A. Sutureless repair of postinfarction cardiac rupture. J Cardiac Surg 1988; 3: 491–3.
Padro JM, Mesa JM, Silvestre J, Larrea JL, Caraips JM, Cerron F, et al. Subacute cardiac rupture: repair with a sutureless technique. Ann Thorac Surg 1993; 55: 20–4.
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Kamohara, K., Minato, N., Ikeda, K. et al. Life-saving strategy for left ventricular free wall rupture after acute myocardial infarction. Jpn J Thorac Caridovasc Surg 48, 291–294 (2000). https://doi.org/10.1007/BF03218141
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DOI: https://doi.org/10.1007/BF03218141