Successful Emergent Repair of a Subacute Left Ventricular Free Wall Rupture After Acute Inferoposterolateral Myocardial Infarction

Overview

Journal J Cardiothorac Surg

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2018 Jun 30

PMID 29954429

Citations 3

Authors

Arjan J F P Verhaegh

Wobbe Bouma

Kevin Damman

M Nasser Morei

Massimo A Mariani

Joost M Hartman

Affiliations

Soon will be listed here.

Abstract

Background: Myocardial rupture is an important and catastrophic complication of acute myocardial infarction. A dramatic form of this complication is a left ventricular free wall rupture (LVFWR).

Case Presentation: A 70-year-old man with acute inferoposterolateral myocardial infarction and single-vessel coronary artery disease underwent emergency percutaneous coronary intervention (PCI). The circumflex coronary artery was successfully stented with a drug-eluting stent. Fifty days after PCI the patient experienced progressive fatigue and chest pain with haemodynamic instability. Transthoracic echocardiography showed a covered LVFWR of the lateral wall. The patient underwent successful emergent surgical repair of the LVFWR.

Conclusions: In the current era of swift PCI, mechanical complications of acute myocardial infarction, such as LVFWR, are rare. The consequences, however, are haemodynamic deterioration and imminent death. This rare diagnosis should always be considered when new cardiovascular symptoms or haemodynamic instability develop after myocardial infarction, even beyond one month after the initial event. Timely diagnosis and emergency surgery are required for successful treatment of this devastating complication.

Citing Articles

Perioperative Management of a Patient With Left Ventricular Free Wall Rupture After Myocardial Infarction: A Rare Case Scenario.

Panesar G, Bhende V, Sharma T, Karna S, Tiwari M, Soni K Cureus. 2022; 14(9):e29368.

PMID: 36159358 PMC: 9488860. DOI: 10.7759/cureus.29368.

Left Ventricular Free Wall Rupture After Acute Myocardial Reinfarction Due to In-Stent Thrombosis in COVID-19 Patient.

Karic A, Haxhibeqiri-Karabdic I, Kabil E, Grabovica S, Straus S, Busevac E Acta Inform Med. 2022; 30(1):76-80.

PMID: 35800909 PMC: 9226759. DOI: 10.5455/aim.2022.30.76-80.

Incomplete myocardial rupture following inferolateral myocardial infarction.

Kabaj M, Berezowski M, Przybylski R, Witkowska A, Brzostowicz T, Kosmala W Kardiochir Torakochirurgia Pol. 2020; 17(2):105-106.

PMID: 32728374 PMC: 7379222. DOI: 10.5114/kitp.2020.97271.

References

Reddy S, Roberts W . Frequency of rupture of the left ventricular free wall or ventricular septum among necropsy cases of fatal acute myocardial infarction since introduction of coronary care units. Am J Cardiol. 1989; 63(13):906-11. DOI: 10.1016/0002-9149(89)90137-9. View

Yip H, Wu C, Chang H, Wang C, Cheng C, Chua S . Cardiac rupture complicating acute myocardial infarction in the direct percutaneous coronary intervention reperfusion era. Chest. 2003; 124(2):565-71. DOI: 10.1378/chest.124.2.565. View

Pollak H, Diez W, Spiel R, ENENKEL W, Mlczoch J . Early diagnosis of subacute free wall rupture complicating acute myocardial infarction. Eur Heart J. 1993; 14(5):640-8. DOI: 10.1093/eurheartj/14.5.640. View

Raposo L, Andrade M, Ferreira J, Aguiar C, Couto R, Abecasis M . Subacute left ventricle free wall rupture after acute myocardial infarction: awareness of the clinical signs and early use of echocardiography may be life-saving. Cardiovasc Ultrasound. 2006; 4:46. PMC: 1664587. DOI: 10.1186/1476-7120-4-46. View

Hutchins K, Skurnick J, Lavenhar M, Natarajan G . Cardiac rupture in acute myocardial infarction: a reassessment. Am J Forensic Med Pathol. 2002; 23(1):78-82. DOI: 10.1097/00000433-200203000-00017. View

Oliva P, Hammill S, Edwards W . Cardiac rupture, a clinically predictable complication of acute myocardial infarction: report of 70 cases with clinicopathologic correlations. J Am Coll Cardiol. 1993; 22(3):720-6. DOI: 10.1016/0735-1097(93)90182-z. View

REARDON M, Carr C, Diamond A, Letsou G, Safi H, Espada R . Ischemic left ventricular free wall rupture: prediction, diagnosis, and treatment. Ann Thorac Surg. 1997; 64(5):1509-13. DOI: 10.1016/S0003-4975(97)00776-5. View

Bergman R, Jainandunsing J, Woltersom B, den Hamer I, Natour E . Sutureless management of left ventricle wall rupture; a series of three cases. J Cardiothorac Surg. 2014; 9:136. PMC: 4177065. DOI: 10.1186/s13019-014-0136-2. View

Figueras J, Cortadellas J, Soler-Soler J . Left ventricular free wall rupture: clinical presentation and management. Heart. 2000; 83(5):499-504. PMC: 1760810. DOI: 10.1136/heart.83.5.499. View

10.

Aoyagi S, Tayama K, Otsuka H, Okazaki T, Shintani Y, Wada K . Sutureless repair for left ventricular free wall rupture after acute myocardial infarction. J Card Surg. 2014; 29(2):178-80. DOI: 10.1111/jocs.12286. View

11.

Ibanez B, James S, Agewall S, Antunes M, Bucciarelli-Ducci C, Bueno H . 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European.... Eur Heart J. 2017; 39(2):119-177. DOI: 10.1093/eurheartj/ehx393. View

12.

Sutherland F, Guell F, Pathi V, Naik S . Postinfarction ventricular free wall rupture: strategies for diagnosis and treatment. Ann Thorac Surg. 1996; 61(4):1281-5. DOI: 10.1016/0003-4975(95)01160-9. View

13.

Haddadin S, Milano A, Faggian G, Morjan M, Patelli F, Golia G . Surgical treatment of postinfarction left ventricular free wall rupture. J Card Surg. 2010; 24(6):624-31. DOI: 10.1111/j.1540-8191.2009.00896.x. View

14.

Pretre R, Benedikt P, Turina M . Experience with postinfarction left ventricular free wall rupture. Ann Thorac Surg. 2000; 69(5):1342-5. DOI: 10.1016/s0003-4975(00)01290-x. View

15.

Lopez-Sendon J, Gonzalez A, Lopez de Sa E, Coma-Canella I, Roldan I, Dominguez F . Diagnosis of subacute ventricular wall rupture after acute myocardial infarction: sensitivity and specificity of clinical, hemodynamic and echocardiographic criteria. J Am Coll Cardiol. 1992; 19(6):1145-53. DOI: 10.1016/0735-1097(92)90315-e. View

16.

Batts K, Ackermann D, Edwards W . Postinfarction rupture of the left ventricular free wall: clinicopathologic correlates in 100 consecutive autopsy cases. Hum Pathol. 1990; 21(5):530-5. DOI: 10.1016/0046-8177(90)90010-3. View

17.

Padro J, Mesa J, Silvestre J, Larrea J, Caralps J, Cerron F . Subacute cardiac rupture: repair with a sutureless technique. Ann Thorac Surg. 1993; 55(1):20-3; discussion 23-4. DOI: 10.1016/0003-4975(93)90468-w. View

18.

Blinc A, Noc M, Pohar B, Cernic N, Horvat M . Subacute rupture of the left ventricular free wall after acute myocardial infarction. Three cases of long-term survival without emergency surgical repair. Chest. 1996; 109(2):565-7. DOI: 10.1378/chest.109.2.565. View

19.

Figueras J, Cortadellas J, Evangelista A, Soler-Soler J . Medical management of selected patients with left ventricular free wall rupture during acute myocardial infarction. J Am Coll Cardiol. 1997; 29(3):512-8. DOI: 10.1016/s0735-1097(96)00542-6. View

20.

Figueras J, Curos A, Cortadellas J, Sans M, Soler-Soler J . Relevance of electrocardiographic findings, heart failure, and infarct site in assessing risk and timing of left ventricular free wall rupture during acute myocardial infarction. Am J Cardiol. 1995; 76(8):543-7. DOI: 10.1016/s0002-9149(99)80151-9. View