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Ann Thorac Surg 1982;33:189-191
© 1982 The Society of Thoracic Surgeons


Articles

Delayed Left Ventricular Rupture Secondary to Transatrial Left Ventricular Vent

Robert H. Breyer, M.D.*, Sidney Lavender, M.M.Sc., A. Robert Cordell, M.D.

From the Section on Cardiothoracic Surgery, Department of Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC

Accepted for publication March 5, 1981.

* Address reprint requests to Dr. Breyer, Section on Cardiothoracic Surgery, Bowman Gray School of Medicine, 300 S Hawthorne Rd, Winston-Salem, NC 27103

The cases of 2 patients with delayed ventricular rupture secondary to ventricular venting through the left atrium during myocardial revascularization are reported. Both patients were weaned from cardiopulmonary bypass without difficulty and were transported to the intensive care unit in good condition. Rupture occurred in one patient two hours later and in the other, approximately twelve hours postoperatively; both patients died. Both patients were short in stature, and it is possible that advancing the catheter to the first guide mark left the tip unusually close to the ventricular apex. As the catheter cooled and hardened and as the heart was retracted, the catheter may have been pushed against the apical endocardium, thereby producing undetectable subendocardial damage. Our experience with these 2 patients has led us to become more selective in venting for coronary bypass operations. When venting is necessary, we insert the catheter so that its tip barely enters the ventricle.




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Ann. Thorac. Surg., September 1, 1987; 44(3): 312 - 314.
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Relative Efficacy of Left Ventricular Venting and Venous Drainage Techniques Commonly Used during Coronary Artery Bypass Graft Surgery
Ann. Thorac. Surg., October 1, 1983; 36(4): 444 - 452.
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