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Michael J. Reardon
Angela Diamond
George V. Letsou
Hazim J. Safi
Rafael Espada
John C. Baldwin
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Ann Thorac Surg 1997;64:1509-1513
© 1997 The Society of Thoracic Surgeons

Current Reviews

Ischemic Left Ventricular Free Wall Rupture: Prediction, Diagnosis, and Treatment

Michael J. Reardon, MD, Christian L. Carr, Angela Diamond, MD, George V. Letsou, MD, Hazim J. Safi, MD, Rafael Espada, MD, John C. Baldwin, MD

Department of Surgery, Section of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas

Left ventricular free wall rupture is the third leading complication and the second most common cause of death after myocardial infarction. Its occurrence has been considered an unpredictable event usually leading to death. An increased appreciation for the clinical presentation of this syndrome and the nearly ubiquitous use of echocardiography have fostered a rise in the antemortem diagnosis of left ventricular free wall rupture, allowing the possibility of operative repair. Despite the increased reporting of left ventricular free wall rupture, the experience of any one surgeon or surgical group tends to be quite small. We review the current status of rupture prediction, clinical presentation, diagnosis, and treatment options. A recent case of left ventricular free wall rupture referred to the Baylor Cardiothoracic Surgery Group with the misdiagnosis of ruptured dissection of the ascending thoracic aorta is presented to illustrate our approach to this clinical situation.




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