Document Detail


Sutureless patch technique for postinfarction left ventricular rupture.
MedLine Citation:
PMID:  12118810     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left ventricular free wall rupture is an uncommon but catastrophic event after myocardial infarction and is associated with a high mortality. After prompt diagnosis some patients may be salvaged with immediate surgical intervention. Surgical techniques used to seal the rupture vary, as few surgeons have experience with this pathologic process. We report our experience using a sutureless patch technique to treat this entity. METHODS: A review of 6 consecutive patients during an 8-year period who were referred to one cardiac unit with postinfarction left ventricular rupture was conducted. RESULTS: There were 3 men and 3 women with an average age of 71.8 years. All were hemodynamically unstable, and 4 were in electromechanical dissociation. Echocardiography confirmed the diagnosis in 5 patients, and cardiac catheterization had been performed in 4 before rupture. All patients were treated promptly with fluid, inotropic agents, and, if needed, cardiopulmonary resuscitation and pericardiocentesis. Resuscitation was continued in the operating room, and the myocardial tear was sealed with a generous patch of unsupported felt secured to the heart with cyanoacrylate glue. Coronary artery bypass grafting was performed in 3 patients if the anatomy was known. All patients survived to the intensive care unit. One death occurred as a result of severe neurologic injury. Five patients were discharged from the hospital, and all were alive 2 months to 7.5 years after operation. CONCLUSIONS: A sutureless patch technique for the treatment of postinfarction rupture is simple, effective, and associated with a favorable outcome.
Authors:
Kevin Lachapelle; Benoit deVarennes; Patrick L Ergina; Renzo Cecere
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  74     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-16     Completed Date:  2002-08-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  96-101; discussion 101     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiac Surgery, McGill University Health Centre, Montreal, Quebec, Canada. kevin.lachapelle@mcgill.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiac Surgical Procedures*
Coronary Artery Bypass
Cyanoacrylates / therapeutic use*
Female
Heart Rupture, Post-Infarction / surgery*
Hemostasis, Surgical
Humans
Male
Middle Aged
Prostheses and Implants*
Surgical Mesh
Tissue Adhesives / therapeutic use*
Chemical
Reg. No./Substance:
0/Cyanoacrylates; 0/Tissue Adhesives

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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