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Two cases using "epi-endocardial patch repair" for postinfarction left ventricular rupture.

Takeshi Nishina1, Takaaki Koshiji, Kazunobu Nishimura

  • 1Department of Cardiovascular Surgery, Kyoto University Graduate of School of Medicine, Kyoto, Japan.

Journal of Cardiac Surgery
|May 22, 2003
PubMed
Summary

This study presents an "epi-endocardial patch" repair for left ventricular (LV) free wall rupture after myocardial infarction (MI). The novel technique effectively stopped bleeding and preserved LV function in two patients.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Repair Techniques
  • Myocardial Infarction Complications

Background:

  • Left ventricular (LV) free wall rupture post-myocardial infarction (MI) presents significant mortality risks.
  • Current treatments focus on preventing LV dysfunction and further myocardial damage to control bleeding.
  • Effective surgical strategies for LV rupture remain a critical area of research.

Observation:

  • Two cases of LV free wall rupture post-MI were treated with an epicardial patch repair.
  • Deep epicardial sutures were utilized, reaching the LV subendocardial area, termed "epi-endocardial patch" repair.
  • Procedures were performed under beating heart conditions with cardiopulmonary bypass or percutaneous cardiopulmonary support (PCPS).

Findings:

  • The "epi-endocardial patch" repair achieved effective and complete hemostasis in both cases.

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  • Extension of myocardial dissection was successfully blocked, preventing further bleeding.
  • Patients demonstrated prompt recovery of LV function post-repair without new ischemia.

    • Implications:

    • The "epi-endocardial patch" repair offers a potentially safe and effective surgical option for LV free wall rupture.
    • This technique may be feasible under beating heart conditions, potentially reducing surgical invasiveness.
    • Further studies are warranted to validate this approach in a larger patient cohort.