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Surgical Outcome Of Post-infarction Left Ventricular Free Wall Rupture
Chan-Young Na;
Hallym University, Dongtan Hospital, Hwaseong-City, Kyonggi-do, Korea, Republic of
BACKGROUND:Left ventricular free wall rupture (LVFWR) is rare and one of the fatal complications after acute myocardial infarction. Early recognition and aggressive treatment are recommended
METHODS:Between August 1999 and February 2023, eleven patients aged between 64 and 79 developed left ventricular free wall rupture after acute myocardial infarction (mean interval 3.5 days). There was active bleeding (blowout type) in 3 patients, and the other 8 patients were oozing or sealed state. As for the LVFWR repair techniques, there were 8 patients applied with the sutureless technique using Teflon felt and glue, 2 patients applied with the primary suture closure technique, and 1 primary suture and sutureless technique with Teflon felt and glue.
RESULTS:One patient died in the operating room due to bleeding. Cardiovascular stability, as well as hemostasis, was achieved in the other 10 patients. There were 3 early deaths (all 3 cases due to area bleeding, one primary suture, and 2 sutureless and glue). Three patients received percutaneous coronary intervention before discharge. All 8 remaining patients survived and were discharged. Three patients were lost in follow-up. The follow-up was from 2 to 97 months, with 4 exhibiting New York Heart Association (NYHA) class I symptoms and 1 exhibiting NYHA class II symptoms.
CONCLUSIONS:Optimal surgical treatment for post-infarction left ventricular free wall rupture remains controversial. The sutureless technique can be a promising strategy for treating post-infarction left ventricular free wall rupture.
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