RESUMO
Cardiac ruptures are life-threatening complications after acute myocardial infarction. Types of rupture include left ventricle free-wall rupture, ventricular septal rupture, and papillary muscle rupture. Double rupture is defined as the coexistence of two of the above-mentioned forms of rupture. It complicates approximately 0.3% of acute myocardial infarction with the most frequent combination being free-wall rupture and ventricular septal rupture. We present the case of a 74-year-old man whose recent acute myocardial infarction was complicated by a combination of free-wall rupture and ventricular septal rupture. The patient underwent successful surgical treatment of the double myocardial rupture along with bypass grafting.
RESUMO
A 16-year-old boy had a motorcycle accident and was given a diagnosis of blunt aortic injury (BAI) by contrast computed tomography (CT), complicated by diffuse brain injury, lung contusions and blunt liver injury. Despite conservative treatment his anemia worsened and further CT images revealed mediastinal hematoma. It was difficult to perform cardiopulmonary bypass with systemic heparinization because of his multiple injuries and therefore decided to perform endovascular stentgrafting. Aortography revealed that the proximal stent-graft landing zone to be very small, and therefore it was necessary to the cover left common carotid artery. Before stentgrafting, we performed a right subclavian artery-left common carotid artery bypass to attain a sufficient proximal landing zone, and stentgrafting was successful. We concluded that endovascular stentgrafting is an effective initial treatment for BAI complicated with multiple injuries. However, endovascular stentgrafting for BAI has some limitations because of the morphologic and anatomical characteristics of the thoracic aorta in cases of BAI. It is therefore important to perform endovascular stentgrafting for BAI on a case-by-case basis.