[Cardiac rupture secondary to left ventricular venting]

The cases of two patients with cardiac rupture secondary to left ventricular venting are reported. In the first patient, who had an aortocoronary bypass grafting, rupture was found in the posterolateral wall of the left ventricle just before closing the chest. It was successfully managed by placing sutures. The cause of rupture was thought to be the advancing venting cannula tip introduced into the left ventricle from the superior right pulmonary vein. In the second patient, who had MVR, AVR, and VSD and ASD closure, rupture occurred in the posterior wall of the left atrium on the 4th postoperative day. The patient died instantly because of profound hemorrhagic shock. Rupture of the left atrium was thought to have occurred secondary to distension of the left atrial wall incurred by lifting the unusually large heart for inserting and removing the venting cannula. These experiences made us decide to abandon routine left ventricular venting.