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Off-pump hemostasis for left ventricular rupture after myocardial infarction with Hydrofit® and Surgicel®

Hikaru Ishii1, Hidehito Endo2, Hiroshi Tsuchiya2

  • 1Department of Cardiovascular Surgery, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan. hikaru3@dg8.so-net.ne.jp.

General Thoracic and Cardiovascular Surgery
|April 26, 2018
PubMed

Insights

A novel technique using Hydrofit® and Surgicel® achieved hemostasis for left ventricular free wall rupture (LVFWR) after myocardial infarction. This method avoids cardiopulmonary bypass, improving hemodynamic stability in critical patients.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomaterials in Medicine

Background:

  • Left ventricular free wall rupture (LVFWR) is a life-threatening complication following myocardial infarction.
  • Surgical repair of LVFWR often necessitates cardiopulmonary bypass (CPB), which can compromise hemodynamic stability.
  • Effective hemostasis is crucial for managing acute shock in these critical patients.

Observation:

  • An 87-year-old male presented with acute shock attributed to LVFWR post-myocardial infarction.
  • A simple, reproducible technique was employed for hemostasis at the LVFWR site during emergency surgery.
  • The technique involved the application of a composite of Hydrofit® and Surgicel® surgical hemostatic agents.

Findings:

  • Manual application and compression of the Hydrofit® and Surgicel® composite achieved complete hemostasis at the bleeding LVFWR site.
  • This innovative approach successfully obviated the need for cardiopulmonary bypass establishment.
  • The patient's hemodynamic stability was maintained throughout the procedure.

Implications:

  • This technique offers a potentially life-saving, minimally invasive alternative for managing LVFWR.
  • It highlights the utility of advanced hemostatic agents in complex cardiovascular emergencies.
  • Further research may validate this approach for broader clinical application in myocardial infarction complications.

Keywords:
Acute myocardial infarctionLeft ventricle ruptureOff-pump hemostasis

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