Advertisement

Mechanical Complications of Acute Myocardial Infarction

  • Antonino M. Grande
  • Alessandro Mazzola
Chapter

Abstract

Acute myocardial infarction may determine in a low percentage of cases (<1%) mechanical complications that have an increased early and late mortality. The main acute mechanical complications of acute myocardial infarction are the ventricular septal rupture, free wall rupture, and ischemic mitral regurgitation. A rapid diagnosis is mandatory, and it is made by echocardiography. Surgical repair is in most cases performed immediately after diagnosis, and postoperative mortality is high in ventricular septal and free wall ruptures.

Keywords

Acute myocardial infarction Ventricular septal rupture Free wall rupture Ischemic mitral regurgitation Echocardiography Intra-aortic balloon pump 

References

  1. 1.
    French JK, Hellcamp AS, Armstrong PW, Cohen E, Kleiman NS, O’Connor CM, Holmes DR, Hochman JS, Granger CB, Mahaffey KW. Mechanical complications after percutaneous coronary intervention in ST-elevation myocardial infarction (from APEX-AMI). Am J Cardiol. 2010;105:59–63.CrossRefGoogle Scholar
  2. 2.
    Skehan JD, Carey C, Norrell MS, de Belder M, Balcon R, Mills PG. Patterns of coronary artery disease in post-infarction ventricular septal rupture. Br Heart J. 1989;62:268–72.CrossRefGoogle Scholar
  3. 3.
    Pohjola-Sintonen S, Muller JE, Stone PH, et al. Ventricular septal and free wall rupture complicating acute myocardial infarction: experience in the Multicenter Investigation of Limitation of Infarct Size. Am Heart J. 1989;117(4):809–18.CrossRefGoogle Scholar
  4. 4.
    Radford MJ, Johnson RA, Daggett WM Jr, et al. Ventricular septal rupture: a review of clinical and physiologic features and an analysis of survival. Circulation. 1981;64(3):545–53.CrossRefGoogle Scholar
  5. 5.
    Daggett WM, Guyton RA, Mundth ED, Buckley MJ, McEnany MT, Gold HK, Leinbach RC, Austen WG. Surgery for post-myocardial infarct ventricular septal defect. Ann Surg. 1977;186:233–40.CrossRefGoogle Scholar
  6. 6.
    David TE, Feindel CM, Ropchan GV. Reconstruction of the left ventricle with autologous pericardium. J Thorac Cardiovasc Surg. 1987;94:710–4.PubMedGoogle Scholar
  7. 7.
    Arnaoutakis GJ, Conte JV. Repair of postinfarct ventricular septal defect: anterior apical ventricular septal defect. Oper Tech Thorac Cardiovasc Surg. 2014;19(1):96–114. www.optechtcs.com/article/S1522-2942(14)00052-X/pdf.CrossRefGoogle Scholar
  8. 8.
    Arnaoutakis GJ, Zhao Y, George TJ, Sciortino CM, McCarthy PM, Conte JV. Surgical repair of ventricular septal defect after myocardial infarction: outcomes from the society of thoracic surgeons national database. Ann Thorac Surg. 2012;94:436–44; discussion 443–4.CrossRefGoogle Scholar
  9. 9.
    Lee HM, Lee YT, Kim WS, Jeong DS, Park PW, Sung K. Surgical treatment of post-infarction left ventricular free wall rupture: three cases review. Korean J Thorac Cardiovasc Surg. 2013;46:357–61.CrossRefGoogle Scholar
  10. 10.
    Vohra HA, Chaudhry S, Satur CM, Heber M, Butler R, Ridley PD. Sutureless off-pump repair of post-infarction left ventricular free wall rupture. J Cardiothorac Surg. 2006;1:11.CrossRefGoogle Scholar
  11. 11.
    Nishizaki K, Seki T, Fujii A, Nishida Y, Funabiki M, Morikawa Y. Sutureless patch repair for small blowout rupture of the left ventricle after myocardial infarction. Jpn J Thorac Cardiovasc Surg. 2004;52:268–71.CrossRefGoogle Scholar
  12. 12.
    Clements SD, Story WE, Hurst JW, Craver JM, Jones EL. Ruptured papillary muscle. A complication of myocardial infarction: clinical presentation, diagnosis, and treatment. Clin Cardiol. 1985;8:93–103.CrossRefGoogle Scholar
  13. 13.
    Antman EM, Morrow DA. Chapter 55: ST-segment elevation myocardial infarction: management. In: Bonow RO, editor. Braunwald’s heart disease—a textbook of cardiovascular medicine. 9th ed. Philadelphia: Saunders; 2011. p. 1150.Google Scholar
  14. 14.
    Acker MA, Parides MK, Perrault LP, et al. Mitral-valve repair versus replacement for severe ischemic mitral regurgitation. N Engl J Med. 2014;370:23–32.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Antonino M. Grande
    • 1
  • Alessandro Mazzola
    • 2
  1. 1.Department of Cardiac SurgeryIRCCS Fondazione Policlinico San MatteoPaviaItaly
  2. 2.Cardiac SurgeryIRCCS Multimedica Sesto S. GiovanniMilanoItaly

Personalised recommendations