title: Off pump repair of left ventricular rupture following mitral valve replacement: The crucial assistance of the IntraAortic Balloon Pump.
abstract: BACKGROUND
  Left ventricular (LV) rupture is a not as frequent, but potentially lethal complication of mitral valve replacement or repair.
  
  
  METHODS
  We report a case of a 67-year-old man who underwent mitral valve replacement and Cox Maze IV procedure. A massive bleed from the LV rupture was noted postoperatively while the patient was extubated. The control of bleeding was impossible until an IntraAortic Balloon Pump (IABP) was inserted. A bovine pericardial patch was applied, overlapping an extensive epicardial area, perimetrically of the hematoma. Between the epicardium and the pericardial patch we applied an autologous fibrin sealant.
  
  
  CONCLUSIONS
  The off-pump technique used to repair the LV rupture after a MVR, is more feasible when the patient is supported by an IABP that subsequently decreases the tension of the myocardial suture site.
  
  
  CONCLUSIONS
  The IABP, is a necessary device, that decreases the tension along the suture site post a left ventricular rupture following a MVR.
authors.affiliation: Cardiac Surgery Department, Evangelismos General Hospital, Athens, Greece. Electronic address: mihalisargiriou@ath.forthnet.gr.
authors.forename: Mihalis
authors.initials: M
authors.lastname: Argiriou
authors.forename: Vasilis
authors.initials: V
authors.lastname: Patris
authors.forename: Niki
authors.initials: N
authors.lastname: Lama
authors.forename: Orestis
authors.initials: O
authors.lastname: Argiriou
authors.forename: Christos
authors.initials: C
authors.lastname: Charitos