[Myocardial infarctectomy in the acute stage].
Seven patients with ventricular septal perforation or left ventricular free-wall rupture underwent myocardial resection in the acute stage of myocardial infarction. One of them received direct closure of the left ventricle, and the others replacement of myocardium with a Dacron prosthesis. One patient died of cardiac failure 5 days after surgery, and 4 in the late-stage between 2 months and 4 years. The following conclusions are obtained in our patients: 1. Echocardiography is very important for the diagnosis of cardiac free-wall rupture and determination of emergency surgery. 2. An intra-aortic balloon should be inserted in patients with VSP as soon as possible. If general state of the patients had been improved by the procedure, surgery might be withheld until the recovery, otherwise emergency surgery should be considered. 3. Myocardial replacement with a prosthesis seems to be useful when the left ventricular cavity is predicted to be small after resection of the myocardium. 4. The development of assisted circulation would improve a survival rate after the surgery. 5. Systemic managements are also important because the patients sometimes become fatal by non-cardiac complications even if they have survived from circulatory failure.
Yamazaki
Y
Y
Eguchi
S
S
Miyamura
H
H
Hayashi
J
J
Muruyama
Y
Y
Fukuda
J
J
Ohzeki
H
H
Yoshimura
T
T
Fujita
Y
Y
Saito
A
A
D000368:Aged; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged