Left Ventricular Rupture Due to Congenital Partial Defect of the Left Ventricular Free Wall

Area of Science:

• Cardiology
• Pediatric Surgery
• Congenital Heart Disease

Background:

• Total anomalous pulmonary venous connection (TAPVC) is a complex congenital heart defect requiring surgical correction.
• Postoperative complications after neonatal cardiac surgery can be severe and life-threatening.
• Left ventricular (LV) free wall rupture is a rare but critical complication.

Purpose of the Study:

• To report a case of neonatal left ventricular rupture following TAPVC repair.
• To highlight the importance of recognizing congenital LV defects in the context of neonatal cardiac surgery.
• To discuss the management and successful repair of LV rupture in a neonate.

Main Methods:

• Transthoracic echocardiography (TTE) for initial diagnosis of suspected pseudoaneurysm.
• Emergency surgical exploration and repair of left ventricular rupture.
• Utilized double patches closure reinforced with BioGlue for defect repair.

Main Results:

• A neonate developed left ventricular free wall rupture on postoperative day 11 after TAPVC surgery.
• The rupture was attributed to an unrecognized congenital partial defect of the LV free wall.
• Successful surgical repair of the LV rupture was achieved with a favorable postoperative course.

Conclusions:

• Left ventricular rupture can occur in neonates post-cardiac surgery due to undiagnosed congenital LV wall defects.
• Conditions like TAPVC, leading to preoperative LV underfilling, may increase the risk.
• Early diagnosis and prompt surgical intervention are vital for managing LV rupture in this population.