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Generation and Characterization of Right Ventricular Myocardial Infarction Induced by Permanent Ligation of the Right Coronary Artery in Mice
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[Ventricular septal rupture and right ventricular free wall rupture after acute myocardial infarction]

Naoki Masaki1, Manabu Fukasawa, Shuji Toyama

  • 1Department of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|August 7, 2013
PubMed

Insights

This case report details a rare ventricular double rupture (VDR) involving both ventricular septal rupture (VSR) and ventricular free wall rupture (VFR) following acute myocardial infarction. Surgical repair was successful, with the patient surviving and being discharged.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Case Reports

Background:

  • Cardiac rupture is a severe complication of acute myocardial infarction (AMI).
  • Ventricular double rupture (VDR), a combination of two rupture types, is exceptionally rare.
  • Common rupture types include ventricular free wall rupture (VFR), ventricular septal rupture (VSR), and papillary muscle rupture (PMR).

Observation:

  • A 76-year-old female presented with heart failure post-AMI.
  • Echocardiography revealed an apical VSR and pericardial effusion.
  • The patient was diagnosed with VDR, necessitating emergent surgery.

Findings:

  • Intraoperative findings confirmed VFR in the right ventricle, coinciding with the VSR infarction area.
  • Ventricular septal rupture was repaired using an infarction exclusion technique, simultaneously addressing the VFR site.
  • Ventricular free wall rupture was successfully repaired with mattress sutures.

Implications:

  • This case highlights the successful surgical management of a rare VDR (VSR and VFR) following AMI.
  • The described surgical techniques (infarction exclusion and mattress sutures) proved effective.
  • Despite a residual shunt, the patient's survival and discharge indicate a positive outcome for this complex condition.

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