[Left ventricle free wall rupture - a 10-year experience]

Rui Ferreira1, J Gallego, M Mendes

  • 1Serviço de Cardio-Torácica do Hospital de Santa Maria, CHLN, Lisboa.

Insights

Left ventricle free wall rupture, a lethal myocardial infarction complication, can be treated surgically without extracorporeal circulation. This technique offers a safer, quicker option for a previously fatal condition.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Left ventricle free wall rupture is a severe complication of myocardial infarction.
  • It has historically high morbidity and mortality rates.

Purpose of the Study:

  • To evaluate the safety and efficacy of surgical closure of left ventricle free wall rupture without extracorporeal circulation.
  • To assess outcomes in patients treated between 2000 and 2010.

Main Methods:

  • Retrospective analysis of 35 patients undergoing surgical repair for left ventricle free wall rupture.
  • Repair involved direct closure using pericardium/synthetic patches and histoacryl glue, without cardiopulmonary bypass.

Main Results:

  • Mean patient age was 69.5 years, with 65.7% males.
  • Rupture occurred at a mean of 2.9 days post-infarction, frequently involving anterior/lateral walls.
  • 94.7% of patients were in shock pre-operatively.
  • In-hospital mortality was 28.6%, with 86% survival at 2.5 years.
  • Mean ICU stay was 7.9 days.

Conclusions:

  • Surgical repair of left ventricle free wall rupture without extracorporeal circulation is feasible.
  • Despite high initial mortality, the procedure offers a survival benefit for a critical condition.
  • The technique is relatively safe, simple, and quick, improving outcomes for patients with left ventricle free wall rupture.

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