Title : Surgical outcome of post-infarction left ventricular free wall rupture
Abstract:
Background and objectives: Left ventricular free rupture is rare and one of the fatal complications after acute myocardial infarction. Early recognition and aggressive treatment is recommended.
Methods: Between August 1999 and February 2023, eleven patients with ages between 64 and 79 years had development of left ventricular free wall rupture after acute myocardial infarction (mean interval 3.5 days). There was active bleeding (blow-out type) in 3 patients, and the other 8 patients were oozing or sealed state. Left ventricular free wall rupture repair techniques were 9 sutureless technique with Teflon felt and glue, and 2 primary suture closure technique and 1 primary suture and sutureless technique with Teflon felt and glue.
Results: Cardiovascular stability, as well as hemostasis, was achieved in the other 12 patients. There are 3 early death (all 3 cases 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 flow-up. The follow-up was from 2 to 97months, with 4 exhibiting New York Heart Association (NYHA) class I symptoms and 1 exhibiting NYHA class II symptoms.
Conclusion: Optimal surgical treatment for post-infarction left ventricular free wall rupture remains controversial. Thee sutureless technique can be a promising strategy for treatment of post-infarction left ventricular free wall rupture.
