Document Detail


Oozing-type of left ventricular rupture treated under percutaneous cardiopulmonary support without surgical repair.
MedLine Citation:
PMID:  12197604     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 65-year-old man was admitted to the National Defense Medical College Hospital for acute anterolateral myocardial infarction and cardiogenic shock. Emergency coronary angiography demonstrated occlusion of the proximal left anterior descending artery. Primary percutaneous transluminal coronary angioplasty (PTCA) was successfully performed with the support of intra-aortic balloon pumping (IABP) and medical treatment to stabilize the patient's blood pressure. On the second hospital day, the patient suffered cardiac tamponade. Pericardiocentesis showed bloody fluid and revealed that an oozing-type of left ventricular rupture had occurred after the myocardial infarction. Cardiogenic shock persisted after successful removal of the pericardial effusion. Although the heparinization required during percutaneous cardiopulmonary support (PCPS) can increase pericardial effusion, PCPS was initiated to correct the systemic hypoperfusion; a surgical team was on standby in case massive pericardial effusion resulted, but fortunately that did not occur, and cardiac function recovered. The patient was weaned successfully from PCPS and IABP and has remained in a satisfactory condition for over 1 year. PCPS contributed to the patient's recovery from cardiac shock and may have decreased the effusion from the oozing-type rupture by reducing ventricular wall tension.
Authors:
Nobuyuki Masaki; Koh Arakawa; Tadashi Yamagishi; Takanori Tahara; Kouji Miyazaki; Toshio Shibuya; Nobuo Hatori; Hiroshi Yoshizu; Tutomu Tanaka; Fumitaka Ohsuzu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  66     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-28     Completed Date:  2003-03-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  769-72     Citation Subset:  IM    
Affiliation:
First Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Drainage
Electric Countershock
Heart Rupture, Post-Infarction / complications*,  therapy*
Heart Ventricles
Heart-Assist Devices*
Humans
Male
Pericardial Effusion / etiology*,  therapy
Respiration, Artificial*
Shock, Cardiogenic / complications
Tachycardia, Ventricular / complications,  therapy

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