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Acute left ventricular free wall rupture treated by percutaneous intra-pericardial fibrin-glue infusion

  • Ayumi Suzuki
  • Joji Ishikawa
  • Yoshiko Nemoto
  • Jun Tanaka
  • Takashi Nishimura
  • Shunei Kyo
  • Kazumasa Harada
Case image in cardiovascular ultrasound
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A 65-year-old woman was admitted to our hospital with left shoulder pain for 3 days, and subacute inferior myocardial infarction was suspected. Three years prior to presentation, she underwent implantation of 3 drug-eluting stents [one to the mid-left anterior descending artery and the others to the mid-right coronary artery (RCA)] for angina pectoris. Transthoracic echocardiography (TTE) produced unclear images because she had breast implants. Emergency coronary angiography (CAG) did not reveal significant stenosis or occlusion, but there was a filling defect in one of the RCA stents. Her anti-platelet therapy was changed, and we continued to administer intravenous heparin for 5 days because of persistent back pain. On the 6th hospital day, complete atrioventricular block with ST-segment elevation in inferior leads was noted. Emergency CAG was performed, and occlusion of the distal RCA was identified. Immediately after CAG, the patient went into cardiopulmonary arrest. Resuscitation...

Notes

Compliance with ethical standards

Conflict of interest

Ayumi Suzuki, Joji Ishikawa, Yoshiko Nemoto, Jun Tanaka, Takashi Nishimura, Shunei Kyo, and Kazumasa Harada declare that they have no conflict of interest.

Human rights statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from the patient for being included in this report.

References

  1. 1.
    Murata H, Masuo M, Yoshimoto H, et al. Oozing type cardiac rupture repaired with percutaneous injection of fibrin-glue into the pericardial space. Jpn Circ J. 2000;64:312–5.CrossRefPubMedGoogle Scholar
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    Ogiwara M. Treatment of left ventricular free wall rupture with fibrin-glue in dogs. Jpn J Cardiovasc S. 1995;24:18–23 (in Japanese).CrossRefGoogle Scholar
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    Hattori R, Otani H, Omiya H, et al. Fate of fibrin sealant in pericardial space. Ann Thorac Surg. 2000;70:2132–6.CrossRefPubMedGoogle Scholar
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    Figueras J, Cortadellas J, Evangelista A, et al. Medical management of selected patients with left ventricular free wall rupture during acute myocardial infarction. J Am Coll Cardiol. 1997;29:512–8.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Echocardiography 2018

Authors and Affiliations

  • Ayumi Suzuki
    • 1
  • Joji Ishikawa
    • 1
  • Yoshiko Nemoto
    • 1
  • Jun Tanaka
    • 1
  • Takashi Nishimura
    • 2
  • Shunei Kyo
    • 2
  • Kazumasa Harada
    • 1
  1. 1.Department of CardiologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
  2. 2.Department of Cardiac SurgeryTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan

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