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Double cardiac rupture after direct infarct coronary angioplasty: report of a case
1Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Insights
Double cardiac rupture (DCR) is rare after direct infarct coronary angioplasty (DICA). This case highlights a patient who developed DCR, including a postinfarction ventricular septal defect and left ventricular free wall rupture, after delayed DICA.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Direct infarct coronary angioplasty (DICA) is a critical intervention for acute myocardial infarction.
- Double cardiac rupture (DCR) is a rare but catastrophic complication following myocardial infarction.
Observation:
- A patient undergoing delayed DICA experienced successful recanalization.
- Despite successful reperfusion, the patient subsequently developed DCR, manifesting as a postinfarction ventricular septal defect (PIVSD) and left ventricular free wall rupture (LVFWR).
Findings:
- This case presents an extremely uncommon instance of DCR occurring after a technically successful DICA.
- The patient required emergency surgical intervention for the combined cardiac ruptures.
Implications:
- The case underscores the potential for severe complications even after successful revascularization in myocardial infarction.
- Understanding the mechanisms of DCR after delayed DICA is crucial for improving patient outcomes and management strategies.
- This report contributes to the limited literature on DCR, offering insights into its occurrence in the context of percutaneous coronary intervention.
Abstract:
The occurrence of double cardiac rupture (DCR) after a successful direct infarct coronary angioplasty (DICA) is extremely uncommon. We describe herein the case of a patient who underwent delayed DICA and despite successful recanalization, subsequently suffered DCR, as a postinfarction ventricular septal defect (PIVSD) with left ventricular free wall rupture (LVFWR). Emergency surgery was performed, and the patient is now doing well more than 2 years after his operation. The possible mechanisms of DCR after delayed DICA are discussed following the presentation of this unusual case.