title: [Surgical treatment for subacute left ventricular free wall rupture complicating acute myocardial infarction--pericardial patch gluing method].
abstract: We reviewed 22 cases with surgical repair for subacute left ventricular free wall rupture complicating acute myocardial infarction. Different operative technique was used. Direct closure or patch repair with infarctectomy was preformed in first patients with a great difficulty in hemostasis. Since 1988 we sutured a large pericardial patch covering the infarcted myocardium under extra corporeal circulation in 11 patients (pericardial patch suture technique). From 1993 we began to glue a pericardial patch with Aron alpha without cardiopulmonary bypass (pericardial patch gluing technique). There were eight early death and four late death. Most common cause of death was low cardiac output syndrome (LOS). With medical therapy 13 patients in cardiogenic shock improved before surgery and only three developed postoperative LOS, but all six patients with sustained shock developed LOS without survivor (p = 0.007). Two of the five patients underwent direct closure or infarctectomy and seven of the 11 employed pericardial patch suture technique developed LOS, but none of the six used pericardial patch gluing technique developed LOS. Medical treatment such as intraaortic balloon pumping, catecholamine and subxyphoid drainage in order to improve hemodynamic condition before surgery is extremely important. Pericardial patch gluing technique seems to be useful since cardiac function would be maximally preserved.
authors: Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan.
authors: T
authors: T
authors: Komiya
authors: O
authors: O
authors: Ishii
authors: K
authors: K
authors: Yamazaki
authors: K
authors: K
authors: Yamada
authors: K
authors: K
authors: Kochi
authors: Y
authors: Y
authors: Kanzaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003487:Cyanoacrylates / Q000627:therapeutic use; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D014014:Tissue Adhesives / Q000627:therapeutic use*
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives; C017025:aron alpha