Cor Vasa 2015, 57(5):e359-e361 | DOI: 10.1016/j.crvasa.2015.02.004

New modalities of surgical treatment for postinfarction left ventricular free wall rupture: A case report and literature review

Miroslav Koňařík^*, Martin Pokorný, Jan Pirk, Ivan Netuka, Ondrej Szárszoi, Jiří Malý

Klinika kardiovaskulární chirurgie, Institut klinické a experimentální medicíny, Praha, Česká republika

Left ventricular free wall rupture (LVFWR) is the third leading and most feared complication of myocardial infarction. The course of rupture varies from a catastrophic blow-out type to a subacute oozing type. The widespread availability and use of echocardiography have increased the number of cases diagnosed before death and the number of surgical cases attempted. Despite this, experience with this entity is still quite small and LVFWR remains the second most common cause of death after myocardial infarction with estimated mortality of about 20%. Survival of the critically ill patients depends on the early diagnosis, hemodynamic stabilization of the patient and prompt surgical repair. The aim of an emergent operation for LVFWR is to rescue the patients at risk of death by bleeding and cardiac tamponade. We present a case of oozing type postinfarction cardiac rupture that was treated by a sutureless technique using a fibrin tissue-adhesive collagen fleece TachoSil® (Takeda, Osaka, Japan) combined with bovine pericardial patch anchored by fibrin glue.

Keywords: Acute mitral regurgitation; Cardiac tamponade; Left ventricular free wall rupture; Myocardial infarction; Pseudoaneurysm; Sutureless technique

Received: January 15, 2015; Revised: February 9, 2015; Accepted: February 12, 2015; Published: October 1, 2015  Show citation