Sutureless Treatment for Blow-out Type Left Ventricular Free Wall Rupture

(Department of Cardiovascular Surgery, Kikuna Memorial Hospital, Yokohama, Japan)

Yutaka Narahara Atsushi Bito Noboru Murata
A 78-year-old woman who had had chest pain since 3 days previously, was given a diagnosis of acute myocardial infarction. Emergency coronary angiography revealed mid-left anterior descending artery and proximal right coronary artery lesions. Percutaneous coronary intervention was performed, and re-perfusion was successful. Cardiac tamponade was then diagnosed. Despite pericardial drainage, she remained in shock. After an intra-aortic balloon pump was established, an emergency operation was performed. On the operating table, her pulse disappeared. When thoracotomy was performed, a viscous hematoma was found in the pericardium. We found 3 ruptures in the left ventricular free wall, and hemorrhage. The diagnosis was a blow-out type left ventricular free wall rupture of the heart(LVFWR). We have used the patches-and-glue sutureless technique without cardiopulmonary support. This treatment for blow-type of LVFWR is rare.
  Jpn. J. Cardiovasc. Surg. 39:254-257(2010)

Keywords:left ventricular free wall rupture, blow-out type, sutureless technique