title: Survival after simultaneous left ventricular free wall, papillary muscle, and ventricular septal rupture.
abstract: Cardiac rupture is a catastrophic complication of acute myocardial infarction. The three potential sites of rupture are the left ventricular free wall, interventricular septum, and papillary muscle. Without rapid surgical correction, each of these complications typically leads to cardiogenic shock, multiorgan failure, and death. Postmortem analysis has identified a small number of cases in which myocardial infarction led to rupture at more than one of these sites; however, there are no reports of survival from such an event. We report a case involving rupture at all three sites in the same patient, emphasizing the importance of transesophageal echocardiography and surgical management.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Walts
authors.forename: A Marc
authors.initials: AM
authors.lastname: Gillinov
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004630:Emergencies; D006323:Heart Arrest / Q000209:etiology; D006342:Heart Rupture, Post-Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D007431:Intraoperative Complications / Q000601:surgery; D008297:Male; D008944:Mitral Valve Insufficiency / Q000601:surgery; D009203:Myocardial Infarction / Q000150:complications*; D010210:Papillary Muscles / Q000000981:diagnostic imaging; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery