Midterm Clinical and Echocardiographic Results With Patch Glue Repair of Left Ventricular Free Wall Rupture
- 9 September 2003
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 108 (10_suppl_1), II-237-II-240
- https://doi.org/10.1161/01.cir.0000089042.80722.7a
Abstract
Background— Left ventricular free wall rupture (LVFWR) is a dramatic complication after myocardial infarction. We present our mid-term clinical and echocardiographic results of LVFWR with an epicardial patch without cardiopulmonary bypass. Methods— From February 1993 to May 2001, 17 patients underwent surgery for LVFWR. The mean age±SD of 12 males and 5 females was 68±10 years. All patients presented for emergency surgery with cardiac tamponade confirmed on echocardiography. After opening the chest and identification of the site of rupture, a Goretex patch was fashioned and applied with enbucrilate surgical glue. Results— Effective control of bleeding was achieved in all cases. There were no on-table deaths. The operative (30 day) mortality was 23.5% (4/17). One death occurred because of patch failure, two because of cardiogenic shock, and one from pneumonia. On follow-up at a median of 2.2 years (interquartile range, 1.1 to 4.3 years), two further deaths occurred, one from myocardial infarction and another of undetermined etiology. Echocardiography did not reveal any evidence of restriction to left ventricular free wall motion. Conclusions— Patch glue repair is expedient, simple and effective; with no adverse effects on mid-term ventricular dynamics. In view of superior published results to infarctectomy and repair with extra corporeal circulation, it should be considered to be the initial procedure of choice for the surgical repair of LVFWR.Keywords
This publication has 21 references indexed in Scilit:
- Experience with postinfarction left ventricular free wall ruptureThe Annals of Thoracic Surgery, 2000
- Ischemic Left Ventricular Free Wall Rupture: Prediction, Diagnosis, and TreatmentThe Annals of Thoracic Surgery, 1997
- Postinfarction ventricular free wall rupture: Strategies for diagnosis and treatmentThe Annals of Thoracic Surgery, 1996
- Identification and Treatment of Complications of Myocardial InfarctionMayo Clinic Proceedings, 1995
- Ventricular Free-Wall Rupture after Myocardial InfarctionSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1991
- Ventricular septal and free wall rupture complicating acute myocardial infarction: Experience in the Multicenter Investigation of Limitation of Infarct SizeAmerican Heart Journal, 1989
- Technique for Repair of Left Ventricular Free Wall RuptureThe Annals of Thoracic Surgery, 1988
- Diagnosis and Treatment of Subacute Free Wall Ventricular Rupture after InfarctionThe Annals of Thoracic Surgery, 1983
- Postinfarction Cardiac Rupture: Surgical Success and Review of the LiteratureThe Annals of Thoracic Surgery, 1978
- Cardiac rupture—challenge in diagnosis and managementThe American Journal of Cardiology, 1977