title: Midterm clinical and echocardiographic results with patch glue repair of left ventricular free wall rupture.
abstract: BACKGROUND
  Left ventricular free wall rupture (LVFWR) is a dramatic complication after myocardial infarction. We present our mid-term clinical and echocardiographic results of LVFWR with an epicardial patch without cardiopulmonary bypass.
  
  
  METHODS
  From February 1993 to May 2001, 17 patients underwent surgery for LVFWR. The mean age+/-SD of 12 males and 5 females was 68+/-10 years. All patients presented for emergency surgery with cardiac tamponade confirmed on echocardiography. After opening the chest and identification of the site of rupture, a Goretex patch was fashioned and applied with enbucrilate surgical glue.
  
  
  RESULTS
  Effective control of bleeding was achieved in all cases. There were no on-table deaths. The operative (30 day) mortality was 23.5% (4/17). One death occurred because of patch failure, two because of cardiogenic shock, and one from pneumonia. On follow-up at a median of 2.2 years (interquartile range, 1.1 to 4.3 years), two further deaths occurred, one from myocardial infarction and another of undetermined etiology. Echocardiography did not reveal any evidence of restriction to left ventricular free wall motion.
  
  
  CONCLUSIONS
  Patch glue repair is expedient, simple and effective; with no adverse effects on mid-term ventricular dynamics. In view of superior published results to infarctectomy and repair with extra corporeal circulation, it should be considered to be the initial procedure of choice for the surgical repair of LVFWR.
authors.affiliation: Department of Cardiac Surgery, University General Hospital, Valencia, Spain. sjcanovas@comv.es
authors.forename: Sergio J
authors.initials: SJ
authors.lastname: Canovas
authors.forename: Eric
authors.initials: E
authors.lastname: Lim
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Dalmau
authors.forename: Maria
authors.initials: M
authors.lastname: Bueno
authors.forename: Jose
authors.initials: J
authors.lastname: Buendía
authors.forename: Fernando
authors.initials: F
authors.lastname: Hornero
authors.forename: Oscar
authors.initials: O
authors.lastname: Gil
authors.forename: Rafael
authors.initials: R
authors.lastname: Garcia
authors.forename: Rafael
authors.initials: R
authors.lastname: Paya
authors.forename: Jose
authors.initials: J
authors.lastname: Perez
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Echanove
authors.forename: Jose
authors.initials: J
authors.lastname: Montero
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006342:Heart Rupture, Post-Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D016019:Survival Analysis; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D014014:Tissue Adhesives