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Off-pump hemostasis for left ventricular rupture after myocardial infarction with Hydrofit® and Surgicel®

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Abstract

Left ventricular free wall rupture (LVFWR) is a catastrophic complication of myocardial infarction. In these cases, cardiopulmonary bypass (CPB) should be performed for left ventricular repair, but can impact hemodynamic stability. An 87-year-old man presented with acute shock. He was diagnosed with LVFWR after myocardial infarction. We describe a simple, effective, and reproducible technique to achieve hemostasis at the LVFWR site during emergency operation using Hydrofit® and Surgicel® surgical hemostatic agents. We simply placed and manually pressed the Hydrofit® and Surgicel® composite on the bleeding site. This technique provides complete hemostasis without CPB establishment.

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Author information

Correspondence to Hikaru Ishii.

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Conflict of interest

Hikaru Ishii, MD, Hidehito Endo, MD, Hiroshi Tsuchiya, MD, Yusuke Inaba, MD, Katsunari Terakawa, MD, and Hiroshi Kubota, MD declare that they have no conflict of interest.

Electronic supplementary material

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Supplementary Video 1: Composite seat made from Hydrofit® and Surgicel® is placed and pressed on the bleeding site manually hemostasis is achieved after approximately three minutes of application (MP4 7468 KB)

Supplementary Video 1: Composite seat made from Hydrofit® and Surgicel® is placed and pressed on the bleeding site manually hemostasis is achieved after approximately three minutes of application (MP4 7468 KB)

Supplementary Video 2: No pseudoaneurysm is observed on the postoperative computed tomography scan (MP4 4297 KB)

Supplementary Video 2: No pseudoaneurysm is observed on the postoperative computed tomography scan (MP4 4297 KB)

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Ishii, H., Endo, H., Tsuchiya, H. et al. Off-pump hemostasis for left ventricular rupture after myocardial infarction with Hydrofit® and Surgicel®. Gen Thorac Cardiovasc Surg 66, 753–755 (2018) doi:10.1007/s11748-018-0928-8

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Keywords

  • Acute myocardial infarction
  • Left ventricle rupture
  • Off-pump hemostasis