Skip to main content
SpringerLink
Log in

Surgical Management of Mechanical Complications of Acute Coronary Syndromes Causing Cardiogenic Shock

  • Chapter
Cardiogenic Shock

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 154 Accesses

Abstract

Approximately 15% of all patients suffering a fatal myocardial infarction die of myocardial rupture. Eighty-five percent of these deaths are from ventricular free wall ruptures. Ventricular septal ruptures (VSDs) and papillary muscle ruptures account for 10% and 5%, respectively (1,2). The natural history of these ruptures is dismal and, therefore, expeditious surgical repair is generally advocated. The focus of this chapter will be the surgical treatment of mechanical complications of acute coronary syndrome and myocardial infarction that result in cardiogenic shock. (An additional presentation of these mechanical complications is provided in Chapter 8. Chapter 7 contains discussions about anesthesia and surgical revascularization techniques.)

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Vlodaver Z, Edwards JE. Rupture of ventricular septum or papillary muscle complicating myocardial infarction. Circulation 1977; 55: 815–822.

    Article  PubMed  CAS  Google Scholar 

  2. Wei JY, Hutchins GM, Bulkley BH. Papillary muscle rupture in fatal acute myocardial infarction: A potentially treatable form of cardiogenic shock. Ann Intern Med 1979; 90: 149–152.

    Article  PubMed  CAS  Google Scholar 

  3. Lundberg S, Sodestrom J. Perforation of interventricular septum in myocardial infarction: a study based on autopsy material. Acta Med Scand 1962; 172: 413–422.

    Article  PubMed  CAS  Google Scholar 

  4. Cooley DA, Belmonte BA, Zeis LB, et al. Surgical repair of ruptured interventricular septum following acute myocardial infarction. Surgery 1957; 41: 930–937.

    PubMed  CAS  Google Scholar 

  5. Madsen JC, Daggett WM Jr. Postinfarction VSD and free wall rupture. In: Edmunds LH Jr, ed. Cardiac Surgery in the Adult. McGraw-Hill, New York, 1997, pp. 629–655.

    Google Scholar 

  6. Edwards BS, Edwards WD, Edwards JE. Ventricular septal rupture complicating acute myocardial infarction: identification of simple and complex types in 53 autopsied hearts. Am J Cardiol 1984; 54: 1201–1205.

    Article  PubMed  CAS  Google Scholar 

  7. Deville C, Fontan F, Chevalier JM, Madonna F, Ebner A, Besse P. Surgery of post-infarction ventricular defect: risk factors for hospital death and long-term results. Eur J Cardiothorac Surg 1991; 5: 167–175.

    Article  PubMed  CAS  Google Scholar 

  8. Fananapazir L, Bray CL, Dark JF. Right ventricular dysfunction and surgical outcome in postinfarction ventricular septal defect. Eur Heart J 1983; 4: 155–167.

    Article  PubMed  CAS  Google Scholar 

  9. David TE, Dale L, Sun Z. Postinfarction ventricular septal rupture: repair by endocardial patch with infarct exclusion. J Thorac Cardiovasc Surg 1995; 110: 1315–1322.

    Article  PubMed  CAS  Google Scholar 

  10. Giuliani ER, Danielson GK, Pluth JR, et al. Postinfarction ventricular septal rupture: surgical considerations and results. Circulation 1974; 49: 455–459.

    Article  PubMed  CAS  Google Scholar 

  11. Daggett WM, Guyton RA, Mundth ED, et al. Surgery for post-myocardial infarct VSD. Ann Surg 1977; 186: 260–270.

    Article  PubMed  CAS  Google Scholar 

  12. Nishimura RA, Schaff HV, Gersh BJ, et al. Early repair of mechanical complications after acute myocardial infarction. JAMA 1986; 256: 47–50.

    Article  PubMed  CAS  Google Scholar 

  13. Daggett WM, Buckley MJ, Akins CW, et al. Improved results of surgical management of postinfarction ventricular septal rupture. Ann Surg 1982; 196: 269–277.

    Article  PubMed  CAS  Google Scholar 

  14. Montoya A, McKeever L, Scanlon P, et al. Early repair of ventricular septal rupture after infarction. Am J Cardiol 1980; 45: 345–348.

    Article  PubMed  CAS  Google Scholar 

  15. Madsen JC, Daggett Jr. WM. Repair of postinfarction VSDs. Semin Thorac Cardiovasc Surg 1998; 10: 117–127.

    PubMed  CAS  Google Scholar 

  16. Pretre R, Ye Q, Grunenfelder J, et al. Role of myocardial revascularization in postinfarction ventricular septal rupture. Ann Thorac Surg 2000; 69: 51–55.

    Article  PubMed  CAS  Google Scholar 

  17. Muehrcke DD, Daggett WM, Buckley MJ. Postinfarction VSD repair: effect of coronary artery bypass grafting. Ann Thorac Surg 1992; 54: 876–883.

    Article  PubMed  CAS  Google Scholar 

  18. Skillington PD, Davies RH, Luff AL. et al. Surgical treatment for infarct-related VSDs. J Thorac Cardiovasc Surg 1990; 99: 798–808.

    PubMed  CAS  Google Scholar 

  19. David TE. Operative management of postinfarction VSD. Semin Thorac Cardiovasc Surg 1995; 7: 208–213.

    PubMed  CAS  Google Scholar 

  20. David TE, Armstrong S. Surgical repair of postinfarction VSD by infarct exclusion. Semin Thorac Cardiovasc Surg 1998; 10: 105–110.

    PubMed  CAS  Google Scholar 

  21. Daggett WM, Burwell LR, Lawson DW. Resection of acute ventricular aneurysm and ruptured inter-ventricular septum after myocardial infarction. N Engl J Med 1970; 283: 1507–1514.

    Article  PubMed  CAS  Google Scholar 

  22. Shumaker H. Suggestions concerning operative management of postinfarction VSDs. J Thorac Cardiovasc Surg 1972; 64: 452–457.

    Google Scholar 

  23. Heitmiller R, Jacobs ML, Daggett WM. Surgical management of postinfarction ventricular septal rupture. Ann Thorac Surg 1986; 41: 683–691.

    Article  PubMed  CAS  Google Scholar 

  24. Hill JD, Lary D, Kerth WJ, et al. Acquired VSDs. J Thorac Cardiovasc Surg 1975; 70: 440–450.

    CAS  Google Scholar 

  25. Deja MA, Svostek J, Widenka K. Post infarction VSD-can we do better? Eur J Cardiothorac Surg 2000; 18: 194–201.

    Article  PubMed  CAS  Google Scholar 

  26. Wei JY, Hutchins GM, Bulkley BH. Papillary muscle rupture in fatal acute myocardial infarction: A potentially treatable form of cardiogenic shock. Ann Intern Med 1979; 90: 149–152.

    Article  PubMed  CAS  Google Scholar 

  27. Stevenson RR, Turner WJ. Rupture of a papillary muscle in the heart as a cause of sudden death. Bull Johns Hopkins Hosp 1935; 57: 235.

    Google Scholar 

  28. Davidson S. Spontaneous rupture of a papillary muscle of the heart: a report of three cases and a review of the literature. Mt Sinai J Med 1948; 14: 941.

    Google Scholar 

  29. Austen WG, Sanders CA, Averill JH, et al. Ruptured papillary muscle: Report of a case with successful mitral valve replacement. Circulation 1965; 32: 597–601.

    Article  PubMed  CAS  Google Scholar 

  30. Nishimura RA, Gersh BJ, Schaff HV. The case for an aggressive surgical approach to papillary muscle rupture following myocardial infarction: “From paradise lost to paradise regained.” Heart 2000; 83: 611–613.

    Article  PubMed  CAS  Google Scholar 

  31. Nishimura RA, Schaff HV, Shub C, et al. Papillary muscle rupture complicating acute myocardial infarction: Analysis of 17 patients. Am J Cardiology 1983; 51: 373–377.

    Article  CAS  Google Scholar 

  32. Barbour DJ, Roberts WC. Rupture of a left ventricular papillary muscle during acute myocardial infarction: analysis of 22 necropsy patients. J Am Coll Cardiol 1986; 8: 558–565.

    Article  PubMed  CAS  Google Scholar 

  33. Kirklin JW, Barratt-Boyes BG. Mitral incompetence from ischemic heart disease. In: Kirklin JW, Barratt-Boyes BG, eds. Cardiac Surgery. 2nd ed. Churchhill Livingstone, New York, 1993, pp. 415–422.

    Google Scholar 

  34. Buckley MJ, Mundth ED, Daggett WM, Gold 11K, Leinbach RC, Austen WG. Surgical management of ventricular septal defects and mitral regurgitation complicating acute myocardial infarction. Ann Thorac Surg 1973; 16: 598–609.

    Article  PubMed  CAS  Google Scholar 

  35. Becker AE. Anatomy of the coronary arteries with respect to chronic ischemic mitral regurgitation. In: Vetter HO, Hetzer R, Schmutzler H, eds. Ischemic Mitral Incompetence. Springer-Verlag, New York, 1991, p. 17.

    Chapter  Google Scholar 

  36. Sanders RJ, Neubuerger KT, Ravin A. Rupture of papillary muscles: occurrence of rupture of the posterior muscle in posterior myocardial infarction. Dis Chest 1957; 31: 316–323.

    Article  PubMed  CAS  Google Scholar 

  37. David TE. Techniques and results of mitral valve repair for ischemic mitral regurgitation. J Cardiac Surg 1994; 9 (2 Suppl): 274–277.

    Article  CAS  Google Scholar 

  38. Rankin JS, Hickey MS, Smith LR, et al. Current management of mitral valve incompetence associated with coronary artery disease. J Cardiac Surg 1989; 4: 25–42.

    Article  CAS  Google Scholar 

  39. Tepe NA, Edmunds LH. Operation for acute postinfarction mitral insufficiency and cardiogenic shock. J Thorac Cardiovasc Surg 1985; 89: 525–530.

    PubMed  CAS  Google Scholar 

  40. Killen DA, Reed WA, Wathanacharoen S, Beauchamp G, Rutherford B. Surgical treatment of papillary muscle rupture. Ann Thorac Surg 1983; 35: 243–248.

    Article  PubMed  CAS  Google Scholar 

  41. Harvey W. Complete Works (1647). Willis R (transl.). Sydenham Society, London, p. 127.

    Google Scholar 

  42. Cobbs BW, Hatcher CR, Robinson PH. Cardiac rupture. Three operations with two long-term survivals. JAMA 1973; 223: 532–535.

    Article  PubMed  Google Scholar 

  43. Spiekerman RE, Brandenburg JT, Achor RWP, et al. The spectrum of coronary heart disease in a community of 30,000: A clinicopathologic study. Circulation 1962; 25: 57–65.

    Article  PubMed  CAS  Google Scholar 

  44. Batts KP, Ackermann DM, Edwards WD. Postinfarction rupture of the left ventricular free wall: Clinicopathologic correlates in 100 consecutive autopsy cases. Hum Pathol 1990; 21: 530–535.

    Article  PubMed  CAS  Google Scholar 

  45. Kretz JG, Eisenmann B, Bareiss P, Bauer MC, Desroche P, Kieny R. Acute postinfarction left ventricle rupture. Five operations with three long-term survivals. J Cardiovasc Surg 1985; 26: 244–247.

    CAS  Google Scholar 

  46. O’Rourke MF. Subacute heart rupture following myocardial infarction. Clinical features of a correctable condition. Lancet 1973; 22: 124–126.

    Article  Google Scholar 

  47. Padro JM, Mesa JM, Silveste J, et al. Subacute cardiac rupture: repair with a sutureless technique. Ann Thorac Surg 1993; 55: 20–24.

    Article  PubMed  CAS  Google Scholar 

  48. Zeebregts CJ, Noyez L, Hensens AG, Skotnicki SH, Lacquet LK. Surgical repair of subacute left ventricular free wall rupture. J Card Surg 1997; 12: 416–419.

    Article  PubMed  CAS  Google Scholar 

  49. Coletti G, Torracca M, Zogno M, et al. Surgical management of left ventricular free wall rupture after acute myocardial infarction. Cardiovasc Surg 1995; 3: 181–186.

    Article  PubMed  CAS  Google Scholar 

  50. Feneley MP, Chang VP, O’Rourke MF. Myocardial rupture after acute myocardial infarction. Br Heart J 1983; 49: 550–556.

    Article  PubMed  CAS  Google Scholar 

  51. Nunez L, de la Llana R, Sendon L, et al. Diagnosis and treatment of subacute free wall ventricular rupture after infarction. Ann Thorac Surg 1982; 35: 525–529.

    Article  Google Scholar 

  52. Pifarre R, Sullivan HJ, Grieco J, et al. Management of left ventricular rupture complicating myocardial infarction. J Thorac Cardiovasc Surg 1983; 86: 441–443.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Harold M. Burkhart MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph A. Dearani MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Tel-Aviv University, Tel Aviv, Israel

    David Hasdai MD  & Alexander Battler MD  & 

  2. Department of Cardiology, Rabin Medical Center, Petah-Tikva, Israel

    Alexander Battler MD

  3. Internal Medicine and Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA

    Peter B. Berger MD  & David R. Holmes Jr. MD  & 

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

Burkhart, H.M., Dearani, J.A. (2002). Surgical Management of Mechanical Complications of Acute Coronary Syndromes Causing Cardiogenic Shock. In: Hasdai, D., Berger, P.B., Battler, A., Holmes, D.R. (eds) Cardiogenic Shock. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-154-1_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-154-1_10

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-312-1

  • Online ISBN: 978-1-59259-154-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation