Cardiogenic shock due to ventricular rupture. A surgical approach.
Following a posterolateral myocardial infarction, a 57-year-old man developed severe shock which did not respond to catecholamine infusion and intra-aortic balloon counterpulsation. Implantation of a left ventricular assist pump was planned, but at sternotomy free ventricular rupture was identified and repaired. Repair of free-wall ventricular rupture is uncommon because of infrequent antemortem diagnosis. A more aggressive surgical approach of instituting left ventricular assist pumping in those patients with cardiogenic shock refractory to medical therapy and intra-aortic balloon pumping should yield the additional benefit of repair of the rather common but rarely recognized lesion of ventricular rupture.
D006341:Heart Rupture / Q000150:complications* / Q000209:etiology / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012770:Shock, Cardiogenic / Q000209:etiology*