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Off-Pump Multilayered Sutureless Repair for a Left Ventricular Blowout Rupture Caused by Myocardial Infarction in the Second Diagonal Branch Territory.
MedLine Citation:
PMID:  23823122     Owner:  NLM     Status:  Publisher    
A left ventricular (LV) free wall rupture is a highly lethal condition. A 78-year-old female, who collapsed while riding a bike, was admitted to our emergency service 7 days after experiencing chest pain. During admission, she had cardiopulmonary arrest. Though cardiopulmonary resuscitation was successful, computed tomography (CT) showed cardiac tamponade. Emergency surgery was then performed. Pericardiotomy revealed a postinfarction blowout rupture of an aneurysm (2 × 3 × 1 cm) on the anterolateral wall of the LV. The top of the aneurysm had a 2-mm wide blowing blood column. Intra-aortic balloon pumping was initiated. An off-pump multilayered sutureless repair using squares of collagen fleece with fibrinogen-based impregnation (i.e., TachoComb) and gelatin-resorcin-formalin glue (GRF glue) was performed. Postoperative coronary angiography revealed occlusion of the second diagonal branch. The patient was free from re-rupture or aneurysm enlargement. An LV blowout rupture, which was caused by myocardial infarction with a limited tear and necrotic area at the second diagonal branch territory, was successfully treated with an off-pump multilayered sutureless repair by using a TachoComb and GRF glue patch. The thickness of the hemostatic material seemed to help control the bulging of the aneurysm and to prevent further LV aneurysm enlargement and re-rupture.
Susumu Isoda; Tamizo Kimura; Motohiko Osako; Kenji Nishimura; Nozomu Yamanaka; Singo Nakamura; Tadaaki Maehara
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-04
Journal Detail:
Title:  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia     Volume:  -     ISSN:  2186-1005     ISO Abbreviation:  Ann Thorac Cardiovasc Surg     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9703158     Medline TA:  Ann Thorac Cardiovasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
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