New strategy for successful repairment of post infarction cardiac rupture

Abstract

Reperfusion therapy for acute myocardial infarction (AMI) has reduced early mortality, however the incidence of cardiac rupture following AMI has not significantly decreased. Cardiac rupture is a catastrophic complications and there are few reports of patients who have successfully recovered. The percutaneous cardiopulmonary support system (PCPS) is useful in maintaining circulation during circulatory collapse. Surgical interventions using PCPS were performed in eleven patients with cardiac rupture. Attempts at surgical repair were possible in six patients when PCPS was used as the circulatory assist deveice. On the other hand, when PCPS was used as a circulatory assistance device, but none survived. PCPS was used in five patients as both a circulatory assistance device and for surgical support at low temperature (20°C). Two of these five patients survived and were uneventfully discharged. This new strategy of using hypothermic percutaneous cardiopulmonary support bypass should prove to be useful for successful repair of post-infarction rupture.