title: Sutureless repair for left ventricular free wall rupture after acute myocardial infarction.
abstract: We report three cases of left ventricular free wall rupture (LVFWR) after acute myocardial infarction, which were repaired using a sutureless technique without cardiopulmonary bypass. At operation, a sheet of fibrin tissue-adhesive collagen fleece (TachoComb) was secured to the hematoma surrounding the tear and the infarcted area under compression by the surgeon's fingers. After complete hemostasis, several sheets of an absorbable gelatin sponge (Gelfoam) were glued onto the collagen fleece in layers. Intra-aortic balloon pumping was electively performed. Concomitant coronary artery bypass grafting was not carried out. All patients survived the operation but recurrence of the rupture occurred on postoperative day 10 in one patient and an LV aneurysm was found four months after repair in another patient. The sutureless technique may be a simple and fast option for treatment of an oozing type LVFWR; however, careful follow-up is mandatory.
authors.affiliation: Department of Cardiovascular Surgery, Cardiovascular Center, Munakata Suikokai General Hospital, Fukuoka, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Aoyagi
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Tayama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Otsuka
authors.forename: Teiji
authors.initials: T
authors.lastname: Okazaki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shintani
authors.forename: Kumiko
authors.initials: K
authors.lastname: Wada
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kosuga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017809:Fatal Outcome; D005260:Female; D015718:Fibrin Tissue Adhesive; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable; D006341:Heart Rupture / Q000601:surgery*; D006342:Heart Rupture, Post-Infarction / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D012008:Recurrence; D013537:Sutures; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive