[Acute surgically-treated complications of myocardial infarct. Clinical experience and discussion of surgical indications].
Post-infarction free-wall, papillary muscle and septal myocardium rupture yields a lowering mortality, not only due to the improved surgical technique but also to a more careful selection of surgical candidates. The value of pericardial decompression in cases of free-wall rupture is discussed. Echocardiographic evidence of blood in the pericardium after a myocardial infarction is not a direct indication for a diagnostic sampling, decompression or surgery. Pericardiocentesis is not a risk-free procedure and should be limited to patients with life-threatening acute tamponade. Clinical results of 34 patients operated upon for myocardial rupture, regardless of adopted technique or timing of surgery, confirm that the decision about a patient's operability should follow a careful evaluation of the following risk factors in this order: infarct size, age, cardiogenic shock, multiorgan failure, rupture site, cardiac failure and associated diseases.
Dottori
V
V
Università di Genova, Cattedra di Cardiochirurgia.
Barberis
L
L
Parodi
E
E
De Gaetano
G
G
Agostini
M
M
Giambuzzi
M
M
Falcone
F
F
Scoti
P
P
Venere
G
G
D000368:Aged; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006342:Heart Rupture, Post-Infarction / Q000401:mortality / Q000601:surgery*; D006346:Heart Septum; D006801:Humans; D008297:Male; D008875:Middle Aged; D010210:Papillary Muscles; D013997:Time Factors
Le complicanze acute di interesse chirurgico dell'infarto miocardico. Esperienza clinica e discussione dell'indicazione chirurgica.