title: A new hybrid sutureless patch repair utilizing chitosan for left ventricle rupture after myocardial infarction: A case report.
abstract: BACKGROUND
  There are many publications reporting the use of TachoSil sheets for sutureless repair. Trauma doctors have recently reported that chitosan-based sheets can efficiently achieve hemostasis for active bleeding.
  
  
  METHODS
  An 85-year-old man was diagnosed with left ventricle free wall rupture that caused cardiac tamponade and cardiogenic shock. Extracorporeal membrane oxygenator (ECMO) was started immediately and surgical repair was planned. Bleeding occurred from a 1-cm tear in the center of the necrotic area in the territory of the left circumflex artery. The tear was treated with a chitosan-based HemCon Bandage. After hemostasis of the myocardium was achieved, the bandage was peeled off and a patch repair was performed using collagen fleece with fibrinogen-based impregnation. His condition subsequently improved. The tracheal tube was extubated and ECMO was removed 2days after the surgery. One month later, the patient had no complications at his postoperative follow-up visit.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of a hybrid patch repair utilizing chitosan-based sheets for a left ventricle rupture after myocardial infarction. Further studies are necessary to evaluate the short- and long-term efficacy of this procedure, and these results must be compared with those of classical surgical repairs.
  
  
  CONCLUSIONS
  The new hybrid sutureless patch utilizing chitosan was demonstrated as safe, easy and effective.
authors.affiliation: Division of Cardiovascular Surgery, Awaji Medical Center, Hyogo, Japan. Electronic address: yoshimor@gmail.com.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Morimoto
authors.affiliation: Division of Cardiovascular Surgery, Awaji Medical Center, Hyogo, Japan.
authors.forename: Takaki
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: Division of Cardiovascular Surgery, Awaji Medical Center, Hyogo, Japan.
authors.forename: Fumiya
authors.initials: F
authors.lastname: Haba
authors.affiliation: Division of Cardiovascular Surgery, Awaji Medical Center, Hyogo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakahira
keywords: Case report; Chitosan; Left ventricle rupture; Myocardial infarction; Sutureless patch repair; Sutureless repair