[Cardiac rupture secondary to left ventricular venting]

Area of Science:

• Cardiovascular Surgery
• Surgical Complications
• Cardiac Anatomy

Background:

• Left ventricular venting is a technique used during cardiac surgery to decompress the left ventricle.
• Potential complications associated with left ventricular venting include cardiac rupture.
• Understanding the mechanisms of rupture is crucial for preventing adverse outcomes.

Observation:

• Two cases of cardiac rupture following left ventricular venting are presented.
• The first patient experienced posterolateral left ventricular rupture during aortocoronary bypass grafting, managed successfully with sutures.
• The second patient suffered fatal posterior left atrial rupture post-mitral valve replacement, aortic valve replacement, and septal defect closure.

Findings:

• Left ventricular rupture was attributed to the venting cannula tip.
• Left atrial rupture was associated with left atrial wall distension during cannula manipulation.
• These events highlight the risks of cardiac rupture associated with left ventricular venting procedures.

Implications:

• The reported cases suggest that routine left ventricular venting may carry significant risks.
• Abandoning routine left ventricular venting could be a strategy to enhance patient safety in cardiac surgery.
• Further research may be warranted to explore alternative or refined venting techniques.