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A case of ventricular triple rupture after an acute myocardial infarction

Shotaro Kaneko1, Shinichi Suzuki1, Motohiko Goda1

  • 1Department of Surgery, Yokohama City University Hospital, Yokohama, Japan.

SAGE Open Medical Case Reports
|October 13, 2023
PubMed

Insights

This case report details a rare instance of triple ventricular rupture following acute myocardial infarction. The patient experienced ventricular free-wall rupture, septal perforation, and papillary muscle rupture, ultimately succumbing to complications.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Critical Care Medicine

Background:

  • Acute myocardial infarction can lead to life-threatening cardiac ruptures, including ventricular free-wall rupture, ventricular septal perforation, and papillary muscle rupture.
  • These complications significantly increase mortality and morbidity in patients with myocardial infarction.

Observation:

  • A 71-year-old female presented with circulatory collapse post-mitral valve replacement and left ventricular free-wall rupture repair.
  • Mechanical circulatory support with venoarterial extracorporeal membrane oxygenation and intra-aortic balloon pump was initiated.
  • Transthoracic echocardiography identified a ventricular septal perforation, leading to a left-to-right shunt.

Findings:

  • The patient underwent surgical repair of the ventricular septal defect via endoventricular patch plasty.
  • Despite interventions, the patient developed multi-organ failure during a prolonged postoperative course.
  • The patient experienced a fatal outcome on postoperative day 32.

Implications:

  • This case represents the first reported instance of combined ventricular free-wall rupture, ventricular septal perforation, and papillary muscle rupture in the context of acute myocardial infarction.
  • Such complex presentations highlight the critical need for prompt diagnosis and aggressive management strategies in severe myocardial infarction complications.
  • Further research into the mechanisms and optimal treatment of multiple ventricular ruptures is warranted.

Keywords:
Ventricular triple ruptureacute myocardial infarctioncardiac ruptureendoventricular patch plastyventricular septal perforation

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