Surgical Repair of Complications Following Acute Myocardial Infarction / 日本心臓血管外科学会雑誌

ABSTRACT

Sixteen consecutively seen patients underwent surgical repair for complications following acute myocardial infarction. There were two cases with acute mitral regurgitation due to posterior papillary muscle rupture, who underwent mitral valve replacement with a prosthetic valve. There were three cases of postinfarction left ventricular free wall rupture. In all cases, horizontal mattress suture with Teflon felt strip was used in order to close the myocardial tear. The two out of three who survived had been placed on percutaneous cardiopulmonary support prior to the operation. There were 11 cases of postinfarction ventricular septal perforation. The surgical procedures consisted of simple patch closure (Daggett's method) in 7 cases, direct closure in one case, apical amputation in one case and endocardial patch repair with infarct exclusion (Komeda-David method) in the most recent two cases. Six out of eleven survived. Early diagnosis and surgical treatment are mandatory to save these patients. Intraaortic balloon pumping and percutaneous cardiopulmonary support prior to the operation have been used to advantage in some patients.