Document Detail

Surgical treatment for postinfarction left ventricular free wall rupture.
MedLine Citation:
PMID:  18355523     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left ventricular (LV) free wall rupture is a catastrophic complication after acute myocardial infarction. The optimal therapeutic strategy is controversial and the midterm results are unknown. METHODS: Between June 1993 and May 2006, 32 patients with an average age of 73 years (range, from 55 to 96 years) were surgically treated for LV free wall rupture. Sutureless technique (gluing autologous patch to the tear) was applied in all patients. RESULTS: The interval between acute myocardial infarction and the rupture was 33 +/- 42 hours and the interval between the rupture and the operation was 3.6 +/- 2.6 hours. Preoperatively, cardiopulmonary resuscitation was performed in eight cases. Percutaneous cardiopulmonary support was placed in six cases and intraaortic balloon pumping in 20 cases preoperatively. The in-hospital mortality was 15.6%. Two patients died of rerupture within ten days. While there was no rerupture during the follow-up period, five patients developed dyskinetic LV aneurysm and one patient developed LV pseudoaneurysm. CONCLUSIONS: The sutureless technique is a simple and effective option for the surgical treatment for LV free wall rupture. The preoperative moribund condition was highly associated with the operative mortality.
Genichi Sakaguchi; Tatsuhiko Komiya; Nobushige Tamura; Taira Kobayashi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-21     Completed Date:  2008-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1344-6     Citation Subset:  AIM; IM    
Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki City, Okayama, Japan.
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MeSH Terms
Cardiac Surgical Procedures / methods,  mortality*
Cardiopulmonary Bypass / methods,  mortality
Cause of Death*
Cohort Studies
Combined Modality Therapy
Critical Illness
Emergency Treatment / methods
Heart Rupture / diagnosis,  mortality,  surgery
Heart Rupture, Post-Infarction / diagnosis,  mortality,  surgery*
Hospital Mortality / trends*
Intra-Aortic Balloon Pumping
Kaplan-Meiers Estimate
Middle Aged
Pericardium / transplantation*
Retrospective Studies
Risk Assessment
Survival Analysis
Tissue Adhesives
Reg. No./Substance:
0/Tissue Adhesives
Comment In:
Ann Thorac Surg. 2008 Apr;85(4):1346-7   [PMID:  18355524 ]

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