Midterm clinical and echocardiographic results with patch glue repair of left ventricular free wall rupture.
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.
Canovas
Sergio J
SJ
Department of Cardiac Surgery, University General Hospital, Valencia, Spain. sjcanovas@comv.es
Lim
Eric
E
Dalmau
Maria J
MJ
Bueno
Maria
M
Buendía
Jose
J
Hornero
Fernando
F
Gil
Oscar
O
Garcia
Rafael
R
Paya
Rafael
R
Perez
Jose
J
Echanove
Ildefonso
I
Montero
Jose
J
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
D014014:Tissue Adhesives