Document Detail

Intraoperative coronary angiography in postinfarction ventricular free wall rupture: how technology can change diagnostic and therapeutic timing.
MedLine Citation:
PMID:  18390955     Owner:  NLM     Status:  MEDLINE    
Left ventricular free wall rupture often presents with an abrupt onset and rapidly progresses towards cardiogenic shock or electromechanical dissociation. The diagnostic pathway is still a matter of debate: echocardiography is commonly decisive but the assessment of coronary artery status is essential in order to optimize the surgical procedure. However, a preoperative coronary angiography could generate a dramatic delay of surgery. We report a case of a patient with a post-infarction left ventricular free wall rupture presenting with cardiac tamponade and cardiogenic shock who underwent emergency surgery. After cardiopulmonary bypass institution, an intraoperative coronary angiography was performed. Successful repair of the ventricular free wall rupture associated with a well-targeted surgical myocardial revascularization were carried out. This case illustrates how the development of technologically advanced hybrid operating rooms could lead to a new diagnostic and therapeutic approach to this potentially fatal complication.
Augusto D'Onofrio; Nicola Abbiate; Paolo Magagna; Alessandro Fabbri
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-04-07
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  7     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-30     Completed Date:  2008-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  733-5     Citation Subset:  IM    
Division of Cardiac Surgery, San Bortolo Hospital, Viale Rodolfi 37, 36100, Vicenza, Italy.
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MeSH Terms
Cardiac Surgical Procedures*
Cardiac Tamponade / etiology,  radiography,  surgery
Cardiopulmonary Bypass
Coronary Angiography* / instrumentation
Coronary Artery Bypass
Coronary Artery Disease / complications,  radiography*,  surgery
Early Diagnosis
Heart Rupture, Post-Infarction / complications,  radiography*,  surgery
Intraoperative Care
Middle Aged
Operating Rooms / organization & administration
Patient Selection
Shock, Cardiogenic / etiology,  radiography,  surgery
Sternum / surgery
Time Factors
Treatment Outcome
Comment In:
Interact Cardiovasc Thorac Surg. 2008 Aug;7(4):735   [PMID:  18664679 ]
Interact Cardiovasc Thorac Surg. 2008 Aug;7(4):735   [PMID:  18664680 ]

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