Ventricular
rupture is usually a sudden, lethal complication after acute
myocardial infarction (MI). Some patients, however, may survive several hours after ventricular
rupture, and there is time for surgical repair if the diagnosis is made quickly. In 1980 and 1981, 7 patients underwent operation for ventricular
rupture at our institution. Bedside hemodynamic studies with a Swan-Ganz
catheter confirmed the diagnosis of
pericardial tamponade. Urgent operation with
cardiopulmonary bypass was performed. Control of
hemorrhage was obtained by covering the ventricular tear and the surrounding infarcted myocardium with a wide
Teflon patch. Four patients are alive and well 2, 3, 4, and 10 months after operation. Clinically, free wall ventricular
rupture should be suspected when any patient recovering from an acute MI experiences
chest pain and cardiovascular collapse. Bedside hemodynamic monitoring will confirm the diagnosis of
cardiac tamponade, and urgent operation will save some of these patients.