[Recent myocardial infarction and heart wall rupture: analysis of 21 cases surgically treated].
Left ventricular free wall rupture is a catastrophic complication of acute myocardial infarction and prognosis will depend on the prompt diagnosis by echocardiography, extension of infarct size and prompt surgical treatment. From november 1984, 21 patients (14 M, 7 F, mean age 68.4 +/- 6 years) underwent emergency operation at our Institution. Surgical technique included resection of necrotic or scarred myocardium and repair by Teflon strips-reinforced sutures, or by patching with Dacron or autologous pericardium. Associated procedures were LV aneurysmectomy, CABG, LV endoaneurysmorraphy and mitral valve replacement. Hospital mortality was 33% (7/17 pts). The postoperative course was prolonged in one patient, who needed hemodialysis and in 5 patients who needed IAPB counterpulsation. The mean length of stay in UCI was 3-10 days. Mean follow up is 70.4 +/- 41 months and 3 patients died of non cardiac related death. We conclude that despite high hospital mortality, satisfactory results may be obtained by surgical repairy under emergency condition, with good-long term survival, depending on prompt diagnosis and infarct size extension.
Barboso
G
G
Cattedra di Cardiochirurgia, Università degli Studi di Sassari.
Cavozza
C
C
Spaggiari
I
I
Gherli
T
T
D000368:Aged; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors