ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Martin H. McMullan
Michael D. Maples
Thomas L. Kilgore, Jr
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by McMullan, M. H.
Right arrow Articles by Hindman, S. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by McMullan, M. H.
Right arrow Articles by Hindman, S. H.
Related Collections
Right arrow Myocardial infarction

Ann Thorac Surg 2001;71:1894-1899
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Surgical experience with left ventricular free wall rupture

Martin H. McMullan, MDa,b, Michael D. Maples, MDa,b, Thomas L. Kilgore, Jr, MDa,b, Stephen H. Hindman, MDa,b

a Mississippi Baptist Medical Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
b Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA

Address reprint requests to Dr McMullan, Mississippi Baptist Medical Center, 501 Marshall St, Suite 100, Jackson, MS 39202
e-mail: cvsc{at}ucmail.com

Presented at the Forty-seventh Annual Meeting of the Southern Thoracic Surgical Association, Marco Island, FL, Nov 9–11, 2000.

Background. Autopsy studies reveal that left ventricular free wall rupture (LVFWR) accounts for 7% to 24% of deaths after myocardial infarction. The condition occurs up to 10 times more often than papillary muscle or interventricular septal rupture. A high index of suspicion must be maintained to differentiate LVFWR from infarct extension, cardiogenic shock, pulmonary embolus, and even Dressler’s syndrome.

Methods. Since 1980, we have operated on 18 patients with LVFWR. Fourteen patients had experienced "blow-out" rupture associated with cardiogenic shock. Four patients had "stuttering" ruptures, a less spectacular occurrence. Echocardiography was the most important diagnostic tool. Repair was performed, usually using infarctectomy and direct suture closure.

Results. Eleven patients (61%) died after operation, 4 patients as a result of rerupture 1 to 12 hours after operation. Recently, we have used a "patch/glue" technique to repair ruptures in 2 patients. We believe this technique is superior to direct suture closure in preventing rerupture. There have been 7 long-term survivors (39%) from 6 months to 15 years.

Conclusions. Left ventricular free wall rupture is not always sudden and dramatic. Yet, the operating staff must be willing to race to the operating room even with the patient in full resuscitation. Echocardiography is the most sensitive and efficient diagnostic tool. All rupture sites should be aggressively repaired, possibly combining direct suture and patch/glue techniques.




This article has been cited by other articles:


Home page
 ICVTSHome page
A. D'Onofrio, N. Abbiate, P. Magagna, and A. Fabbri
Intraoperative coronary angiography in postinfarction ventricular free wall rupture: how technology can change diagnostic and therapeutic timing
Interactive CardioVascular and Thoracic Surgery, August 1, 2008; 7(4): 733 - 735.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
S. W.M. van den Borne, J. Narula, J. W. Voncken, P. M. Lijnen, H. T.M. Vervoort-Peters, V. E.H. Dahlmans, J. F.M. Smits, M. J.A.P. Daemen, and W. M. Blankesteijn
Defective intercellular adhesion complex in myocardium predisposes to infarct rupture in humans.
J. Am. Coll. Cardiol., June 3, 2008; 51(22): 2184 - 2192.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
R. F. Padera Jr. and F. J. Schoen
Pathology of Cardiac Surgery
Card. Surg. Adult, January 1, 2008; 3(2008): 111 - 178.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
F. A. Atik, J. L. Navia, P. R. Vega, G. V. Gonzalez-Stawinski, J. M. Alster, A. M. Gillinov, L. G. Svensson, B.G. Pettersson, B. W. Lytle, and E. H. Blackstone
Surgical Treatment of Postinfarction Left Ventricular Pseudoaneurysm
Ann. Thorac. Surg., February 1, 2007; 83(2): 526 - 531.
[Abstract] [Full Text] [PDF]

Home page
 ANGIOLOGYHome page
G. Weissman, C. C. Kwon, R. K. Shaw, and J. F. Setaro
Free-Wall Rupture of the Myocardium Following Infarction: A Changing Clinical Portrait in the Reperfusion Era: A Case Report
Angiology, October 1, 2006; 57(5): 636 - 642.
[Abstract] [PDF]

Home page
 Cardiovasc ResHome page
X.-M. Gao, Q. Xu, H. Kiriazis, A. M. Dart, and X.-J. Du
Mouse model of post-infarct ventricular rupture: time course, strain- and gender-dependency, tensile strength, and histopathology
Cardiovasc Res, February 1, 2005; 65(2): 469 - 477.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
S. Fukushima, J. Kobayashi, O. Tagusari, and Y. Sasako
A huge pseudoaneurysm of the left ventricle after simple gluing of an oozing-type postinfarction rupture
Interactive CardioVascular and Thoracic Surgery, March 1, 2003; 2(1): 94 - 96.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
F. J. Schoen and R. F. Padera Jr.
Cardiac Surgical Pathology
Card. Surg. Adult, January 1, 2003; 2(2003): 119 - 185.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
P. Totaro and G. Minzioni
Patch-and-glue technique for left ventricular free wall rupture
Ann. Thorac. Surg., July 1, 2002; 74(1): 294 - 295.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2001 by The Society of Thoracic Surgeons.