Sutureless repair for left ventricular free wall rupture after acute myocardial infarction.

Abstract

We report three cases of left ventricular free wall rupture (LVFWR) after acute myocardial infarction, which were repaired using a sutureless technique without cardiopulmonary bypass. At operation, a sheet of fibrin tissue-adhesive collagen fleece (TachoComb) was secured to the hematoma surrounding the tear and the infarcted area under compression by the surgeon's fingers. After complete hemostasis, several sheets of an absorbable gelatin sponge (Gelfoam) were glued onto the collagen fleece in layers. Intra-aortic balloon pumping was electively performed. Concomitant coronary artery bypass grafting was not carried out. All patients survived the operation but recurrence of the rupture occurred on postoperative day 10 in one patient and an LV aneurysm was found four months after repair in another patient. The sutureless technique may be a simple and fast option for treatment of an oozing type LVFWR; however, careful follow-up is mandatory.

• Authors: Shigeaki Aoyagi, Keiichiro Tayama, Hiroyuki Otsuka, Teiji Okazaki, Yusuke Shintani, Kumiko Wada, Kenichi Kosuga
• Journal: Journal of cardiac surgery (J Card Surg) Vol. 29 Issue 2 Pg. 178-80 (Mar 2014) ISSN: 1540-8191 [Electronic] United States
• PMID: 24428225 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2014 Wiley Periodicals, Inc.

Chemical References

• Fibrin Tissue Adhesive

Topics

• Aged
• Aged, 80 and over
• Fatal Outcome
• Female
• Fibrin Tissue Adhesive
• Follow-Up Studies
• Gelatin Sponge, Absorbable
• Heart Rupture (surgery)
• Heart Rupture, Post-Infarction (surgery)
• Heart Ventricles (surgery)
• Humans
• Intra-Aortic Balloon Pumping
• Male
• Recurrence
• Sutures
• Treatment Outcome