Post-infarction cardiac rupture: surgical treatment.
OBJECTIVE
Rupture of ventricular free wall (VFWR) may complicate acute myocardial infarction and accounts for high mortality. Surgical repair is the only therapeutic option. A review of our surgical experience is presented.


METHODS
Seventeen patients (11 men, mean age 68 years) underwent surgery for VFWR. Patch covering technique was used in 13 patients, infarctectomy with patch reconstruction in three patients, direct suture without patch in one patient. Coronary artery bypass grafting was performed in eleven patients.


RESULTS
Hospital mortality was 17.6% (three patients). Three patients died of cancer during the follow-up. The remaining 11 patients are in good condition after a mean follow-up of 45.8 months (range 7.5-84.2).


CONCLUSIONS
Postinfarction rupture of ventricular free wall treated surgically gives excellent long-term results. Our first choice for repair is the covering technique with a large pericardial patch anchored with biological glue and epicardial sutures.
Mantovani
Vittorio
V
Department of Cardiac Surgery, Ospedale di Circolo-Fondazione Macchi, Università dell'Insubria, Viale Borri 57, 21100 Varese, Italy. vitmantovani@hotmail.com
Vanoli
Davide
D
Chelazzi
Paolo
P
Lepore
Vincenzo
V
Ferrarese
Sandro
S
Sala
Andrea
A
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006342:Heart Rupture, Post-Infarction / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation; D015996:Survival Rate; D016896:Treatment Outcome