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Post-infarction cardiac rupture: surgical treatment
Vittorio Mantovani1, Davide Vanoli, Paolo Chelazzi
1Department of Cardiac Surgery, Ospedale di Circolo-Fondazione Macchi, Università dell'Insubria, Viale Borri 57, 21100 Varese, Italy. vitmantovani@hotmail.com
Summary
Surgical repair of ventricular free wall rupture after myocardial infarction offers excellent long-term survival. The pericardial patch covering technique is the preferred method for this life-threatening complication.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Research
Background:
- Ventricular free wall rupture (VFWR) is a severe complication of acute myocardial infarction.
- VFWR carries a high mortality rate, with surgical repair being the only definitive treatment.
- This study reviews surgical outcomes for VFWR.
Purpose of the Study:
- To evaluate the long-term efficacy of surgical repair for ventricular free wall rupture.
- To present the surgical experience and outcomes at a single institution.
- To identify the optimal surgical technique for VFWR.
Main Methods:
- A retrospective review of 17 patients who underwent surgery for VFWR.
- Surgical techniques included patch covering (13 patients), infarctectomy with patch reconstruction (3 patients), and direct suture (1 patient).
- Coronary artery bypass grafting was performed in 11 patients.
Main Results:
- Hospital mortality was 17.6% (3 patients).
- Long-term survival was good for the remaining 11 patients, with a mean follow-up of 45.8 months.
- Cancer was a cause of death in 3 patients during follow-up.
Conclusions:
- Surgical treatment of postinfarction VFWR yields excellent long-term results.
- The preferred surgical approach is the covering technique using a pericardial patch with biological glue and epicardial sutures.
- Early surgical intervention is crucial for improving outcomes in VFWR.