[Left ventricular free wall rupture].
BACKGROUND
Left ventricular (LV) free wall rupture is an uncommon but catastrophic event after acute myocardial infarction and is associated with a high mortality. Some patients may be salvaged with emergent operation. Padro et al. described a sutureless technique for the treatment of postinfarction LV free wall rupture. We have adopted a similar sutureless technique using a fibrin glue-oxycellulose fixation.


METHODS
A review of 32 patients during a 20-year period who were referred to coronary care unit (CCU) with postinfarction LV free wall rupture was conducted. There were 17 men and 15 women with an average age of 68.8 years. Nine patients were treated who having one-stage operation of simultaneous 7 ventricular septal perforation and 2 coronary artery bypass grafting (CABG). Nine patients were sutured directly with a felt sandwich technique with or without cardiopulmonary bypass. Five patients were treated with pericardiectomy and pericardiocentesis using direct vision. Nine patients were sealed with sutureless method using fibrin glue-oxycellurose fixation without cardiopulmonary bypass.


RESULTS
Eleven hospital deaths (34.4%, 11/32) were occurred in the all patints. However, 1 death (7.1%, 1/14) occurred in the pericardiectomy and in the sutureless sealed groups.


CONCLUSIONS
A sutureless technique for an oozing type of postinfarction LV free wall rupture is effective.
Endo
Masahiro
M
Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan.
Kurosawa
Hironobu
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D065347:Hypromellose Derivatives; D008297:Male; D008747:Methylcellulose / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D010492:Pericardiectomy; D020519:Pericardiocentesis; D015996:Survival Rate; D014014:Tissue Adhesives / Q000627:therapeutic use; D018658:Ventricular Septal Rupture / Q000145:classification / Q000401:mortality / Q000601:surgery*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D065347:Hypromellose Derivatives; D008747:Methylcellulose