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Double cardiac rupture after direct infarct coronary angioplasty: report of a case

J Dudra1, F Okamoto, S Sasaki

  • 1Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan.

Surgery Today
|December 16, 1998
PubMed

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.

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