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Surgical Approach to Myocardial Rupture After Acute Myocardial Infarction

Divisions of Cardiac Surgery 1 Division of Cardiology Saint Vincent Hospital and University of Massachusetts Medical School Worcester, MA, USA

For reprint information contact: A Thomas Pezzella, MD Division of Cardiothoracic Surgery University of Massachusetts Medical Center 55 Lake Avenue North Worcester, MA 01655-0304, USA Tel: 1 508 856 6529 Fax: 1 508 856 3740 Email: thomas.pezzella{at}banyan.ummed.edu

Rupture of the ventricular wall is a highly lethal complication of acute myocardial infarction that is diagnosed more frequently with the increased use of two-dimensional echocardiography. External patching techniques were used to treat 4 patients with ventricular rupture, thus avoiding resection of necrotic myocardium. Three of the patients survived. One patient developed a large left ventricular pseudoaneurysm requiring reoperation. The other 2 patients had intact repairs on follow-up echocardiogram obtained after 5 weeks and 3 years, respectively. With prompt recognition and treatment, patient survival and excellent short-term results can be achieved.

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