Myocardial infarction-related left ventricular rupture with the tear across the ventricular wall detected on echocardiography
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A 79-year-old man underwent repair surgery for a left ventricular free wall rupture after an acute myocardial infarction. The surgical procedure followed for ventricular rupture was according to the rupture type. The patient showed slowly oozing bleeding through small holes. Epicardial echocardiography detected the color signals that crossed the left ventricular wall. Two channels were directly connected from the ventricular cavity to the epicardial hole. Although the bleeding hole was covered with collagen hemostats using a sutureless technique, the bleeding remained, probably because of the pressure exerted by the left ventricle on the channels connected to the epicardial hole. The suture closure technique might be better in cases with channels across the ventricular wall, as detected on echocardiography. We describe a case of left ventricular rupture followed by acute myocardial infarction in which the channel connected to the ruptured ventricular tear was detected on epicardial echocardiography.
KeywordsLeft ventricular free wall rupture Epicardial echocardiography Sutureless technique
The authors thank Dr Daisuke Hotta (Hokkaido Cardiovascular Hospital) for the excellent advice.
Video 1. Surgical images (MPG 12236 KB)
Video 2. Epicardial echocardiographic images (MPG 6294 KB)
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