Left Ventricular Wall Rupture Research Articles

ACTIVE ASSIST CIRCULATION IN “LOS” FOLLOWING CARDIAC SURGERY

In this paper, we report four cases in which active assist circulation was performed using IABP and ECC with aortic cannulation at the ascending aorta to improve left ventricular function that had fallen into severe LOS at or after weaning from cardio pulmonary bypass (CPB) during cardiac surgery. Case 1: 51-year-old female, thrombectomy (LA)+MVR+single ACBG. Case 2:68-year-old female, AVR. Case 3: 51-year-old female, MVR + repair for postoperative rupture of posterior left ventricular wall. Case 4: 48-year-old male, emergency double ACBG. We performed active assist circulation on them at (Cases 1, 2 and 4) or after (Case 3) weaning from CPB. The condition of patients who require active assist circulation is very serious. Thus, it is difficult to treat them completely. When active assist circulation is continued for a long time, hemolysis, infection, ischemia of lower limb, multiple organ failure, etc., may develop, and the patient's prognosis will worsen. Consequently, for severe LOS patients at or after weaning from CPB, efforts must be made to solve these problems and active treatment which can be done at any institute must be given prior to the implementation of an artificial heart.

Left ventricular wall rupture following mitral valve replacement: A report of successful repair

Left ventricular wall rupture following mitral valve replacement: A report of successful repair

主題II-9 僧帽弁置換術における左室後壁破裂

主題II-9 僧帽弁置換術における左室後壁破裂

Rupture of the posterior left ventricular wall after mitral valve replacement and closure of atrial septal defect: A case report

Rupture of the posterior left ventricular wall after mitral valve replacement and closure of atrial septal defect: A case report

Left Ventricular Wall Rupture after Mitral Valve Replacement: Report of Successful Repair in 2 Patients

Left ventricular wall rupture after mitral valve replacement, though uncommon, is a disastrous complication when it does occur. We have experienced this problem in 2 separate instances. Successful treatment was accomplished by suturing a large prosthetic patch over the entire area of laceration and hematoma.

Studies of Myocardial Rupture with Cardiac Tamponade in Acute Myocardial Infarction: I. Clinical Features

The clinical features of cardiac rupture with tamponade in acute myocardial infarction have been studied in an attempt to predict this complication and find clues to prophylactic and therapeutic measures. Eleven cases with rupture of the free left ventricular wall in a consecutive series of 529 coronary care unit (CCU) patients with acute myocardial infarction have been analyzed. These 11 patients accounted for 10 percent of the mortality. The significant features were absence of a history of previous myocardial infarction in association with electrocardiographic (ECG) signs of acute infarction present at time of admission. In no instance was the infarct purely inferior in its location. These characteristics would have given 0.2 percent false negative and 17 percent false positive prediction among these 529 patients with acute myocardial infarction. In seven of the patients the rupture occurred during the first day of the illness. In no case did the rupture occur in massive infarction, which provides a basis for hope of success following surgical intervention in the future.

III. Attempts at Emergency Surgical Treatment

The constant observation of patients in coronary care units (CCUs) permits a rapid diagnosis of rupture of the free left ventricular wall and resulting cardiac tamponade. This has allowed for a surgical trial in three patients to relieve the tamponade and to repair the rupture. No patients survived hospitalization. One patient died of a new rupture six hours after successful repair of the original one. The next patient survived for one month but suffered from severe brain damage as a consequence of excessive bleeding during the intervention. The third patient died during the attempts of suturing a new rupture of the myocardium, three hours after the first rupture. The experience shows that a CCU staff can 1) quickly and correctly diagnose a rupture with tamponade, 2) relieve the tamponade and 3) stop the gross bleeding. The main problem does not seem to be to prevent the myocardial sutures from cutting but rather the occurrence of new ruptures. Further attempts with varying techniques seem justified.