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Abstract: Case Reports |

Alternative Surgical Method for Repair of Postinfarctional Left Ventricular Free Wall Rupture FREE TO VIEW

Laszlo Szekely, MD, PhD; Laszlo Vandor, MD; Andras Haan, MD; Andrea Varga, MD; Tibor Szonyi, MD; Zsolt Piroth, MD; Ferenc Horkay, MD
Author and Funding Information

Gottsegen Gy Hungarian Institute of Cardiology, Section of Cardiac Surgery, Budapest, Hungary


Chest


Chest. 2003;124(4_MeetingAbstracts):295S. doi:10.1378/chest.124.4_MeetingAbstracts.295S
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INTRODUCTION:  Left ventricular free wall rupture (LVFWR) is a rare, but even serious complication of acute myocardial infarction, which is associated with significant mortality and morbidity. Despite of improvements in surgical techniques, it remains a therapeutic challenge. In this report, we discuss the history of a patient, whose LVFWR was repaired by a sutureless technique.CASE PRESENTATIONS: 61-years old male patient was hospitalized after acute myocardial infarction on the regions of anterior wall, apex and septum due to a sudden closure of left anterior descending artery. The coronary arteries, elsewhere, were intact. The left ventricular ejection fraction was reduced to 25%. After recognition of his increasing level of pericardial blood and tamponade, cardiac surgery intervention was immediately carried out. Euroscore: 13, Parsonnet: 37. On the anterior wall, we identified 3 independent bleeding holes in a 4X6 cm region. Utilizing a 5X7 cm PTFE Felt patch and a double component bio adhesive, we glued and successfully repaired the ruptured wall without using fixing sutures. The length of surgery was 63 minutes. The outcome was favorable. At the end of surgery, there was no remaining bleedings from the heart. His recovery period was uneventful and remained free of symptoms throughout the five months of follow up period except a wound healing problem, which occurred in the lower third of his incision and fixed.CONCLUSIONS: Our case demonstrates a possible, alternative way to repair left ventricular free wall rupture, which is safely applicable even if in selected cases.

DISCLOSURE:  L. Szekely, None.

Tuesday, October 28, 2003

4:15 PM - 5:45 PM

References

Canovas SJ, Lim E, Hornero F, Montero J, Surgery for left ventricular free wall rupture: patch glue repair without extracorporeal circulation.Eur J Cardiothorac Surg23(4)2003639–641
 
Mariani MA, D’Alfonso A, Nardi C, Grandjean JG, Left ventricular free wall rupture: off-pump sutureless patch and glue technique.Ital Heart J3(12)2002755–757
 
Lachapelle K, deVarennes B, Ergina PL, Cecere R, Sutureless patch technique for postinfarction left ventricular rupture.Ann Thorac Surg74(1)200296–101
 
Tomcsanyi I, Hajdu L, Szilasy Z, Szekely A, Medgyesy M, Successful new method for surgery of the postinfarctional left ventricular free wall rupture.Orv Hetil142(24)20011269–1271
 

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References

Canovas SJ, Lim E, Hornero F, Montero J, Surgery for left ventricular free wall rupture: patch glue repair without extracorporeal circulation.Eur J Cardiothorac Surg23(4)2003639–641
 
Mariani MA, D’Alfonso A, Nardi C, Grandjean JG, Left ventricular free wall rupture: off-pump sutureless patch and glue technique.Ital Heart J3(12)2002755–757
 
Lachapelle K, deVarennes B, Ergina PL, Cecere R, Sutureless patch technique for postinfarction left ventricular rupture.Ann Thorac Surg74(1)200296–101
 
Tomcsanyi I, Hajdu L, Szilasy Z, Szekely A, Medgyesy M, Successful new method for surgery of the postinfarctional left ventricular free wall rupture.Orv Hetil142(24)20011269–1271
 
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