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Sutureless patch repair for small blowout rupture of the left ventricle after myocardial infarction

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Abstract

Rupture of the left ventricular free wall is one of the most serious complications of myocardial infarction. A 73-year-old man with severe chest pain visited our hospital. Coronary angiography revealed acute myocardial infarction in the territory of the diagonal branch. About six hours after successful percutaneous coronary intervention, the patient fell into cardiogenic shock with chest pain. Echocardiography showed moderate pericardial effusion with a subepicardial hematoma, and percardioentesis led to the diagnosis of free wall rupture. Emergency surgery was performed with the use of intra-aortic balloon pumping. The rupture was a blowout type in a small tear at the anterolateral wall of the left ventricle. We repaired the tear with an off-pump sutureless patch using collagen fleece with fibrinogen-based impregnation (TachoComb™) and equinous pericardium with fibrin spray. The patient was free of both re-rupture and pseudoaneurysm postoperatively, and was discharged 20 days after the operation. Considering previously reported various procedures for surgical repair, this technique may be useful if the tear is small.

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Authors and Affiliations

  1. From Department Cardiology, Nara Prefectural Mimuro Hospital, Nara, Japan

    Atsushi Fujii MD, Yasunori Nishida MD, Masafumi Funabiki MD & Yoshinobu Morikawa MD

  2. Department of Cardiovascular Surgery, Nara Prefectural Mimuro Hospital, 1-14-16 Mimuro, Sango-cho, Ikoma-gun, 636-0802, Nara, Japan

    Kazuhiko Nishizaki MD, Toshio Seki MD, Atsushi Fujii MD, Yasunori Nishida MD, Masafumi Funabiki MD & Yoshinobu Morikawa MD

Authors
  1. Kazuhiko Nishizaki MD
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  2. Toshio Seki MD
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  3. Atsushi Fujii MD
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  4. Yasunori Nishida MD
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  5. Masafumi Funabiki MD
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  6. Yoshinobu Morikawa MD
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Nishizaki, K., Seki, T., Fujii, A. et al. Sutureless patch repair for small blowout rupture of the left ventricle after myocardial infarction. Jpn J Thorac Caridovasc Surg 52, 268–271 (2004). https://doi.org/10.1007/s11748-004-0123-y

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  • DOI: https://doi.org/10.1007/s11748-004-0123-y

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