[Acute rupture of the left ventricle 12 hours after an anteroseptal myocardial infarct. Successful surgical repair].

Academic Article

Abstract

  • Acute rupture of the left ventricular free wall was suspected in a 53 year old hypertensive patient at the 12th hour of primary antero-septo-apical myocardial infarction. He developed acute tamponade with severe cardiogenic shock during his transfer to hospital. Cardiac compression due to hemopericardium was confirmed by M mode echocardiography (pericardial effusion), right heart catheterisation (adiastole and low cardiac output) and pericardial puncture during which several ccs of blood were aspirated leading to a slight improvement in the patient's condition. At operation under cardiopulmonary bypass 2,5 hours after hospital admission, the surgeon found a hemopericardium related to fissuration of an acute apical infarct which was sutured on a Teflon support. The initial postoperative course was complicated by unexplained gastro-intestinal hemorrhage, transient functional renal failure, cardiac failure and mediastinitis, but the final outcome was successful with a follow-up of 24 months. This appears to be the 9th reported case of long-term survival after surgical repair of rupture of the heart in the acute phase of myocardial infarction.
  • Keywords

  • Electrocardiography, Emergencies, Heart Rupture, Heart Ventricles, Humans, Male, Middle Aged, Myocardial Infarction, Time Factors
  • Author List

  • Baudouy PY; Menasche P; Kural S; Wolff M; Piwnica A
  • Start Page

  • 349
  • End Page

  • 354
  • Volume

  • 76
  • Issue

  • 3