Left Ventricular Free Wall Rupture (Blow-Out Type) after Acute Myocardial Infarction: A Case of Successful Surgical Repair / 日本心臓血管外科学会雑誌

ABSTRACT

We describe successful surgical treatment of blow-out type left ventricular free wall rupture (LVFWR) that suddenly occurred in a 66-year-old man 6 days after antero-lateral acute myocardial infarction. Immediate use of a percutaneous cardiopulmonary support system (PCPS) and intra-aortic balloon pumping (IABP) successfully resuscitated the patient, followed by emergency operation for the beating heart under PCPS and IABP. The actively bleeding site, located at the antero-lateral wall, was gently approximated by large bites of mattress suture with pledgets to close the rupture site, and the site was then additionally covered with oxycel and fibrin glue. The infarct area was finally widely covered with a large patch of equine pericardium. This simple surgical method for the beating heart under PCPS and IABP can provide a prompt and less invasive surgical cure for critically ill patients with blow-out type LVFWR.