Perforation due to new myocardial infarction long time; report of a case

A 65-year-old man was admitted to the hospital because of effort chest pain, 8 years after he received coronary artery bypass grafting [CABG: left internal thoracic artery (LITA) to left anterior descending artery (LAD), saphenous vein graft (SVG) to first diagonal branch (D1) and SVG to postero-lat...

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Bibliographic Details
Published inKyobu geka. The Japanese journal of thoracic surgery Vol. 62; no. 3; p. 241
Main Authors Okada, S, Kaneko, T, Ezure, M, Satoh, Y, Hasegawa, Y, Koike, N, Okonogi, S, Takihara, H, Adachi, H
Format Journal Article
LanguageJapanese
Published Japan 01.03.2009
Subjects
Angina Pectoris - surgery
Angioplasty, Balloon, Coronary
Cardiac Surgical Procedures
Coronary Artery Bypass
Humans
Male
Myocardial Infarction - complications
Myocardial Infarction - therapy
Time Factors
Treatment Outcome
Ventricular Septal Rupture - etiology
Ventricular Septal Rupture - surgery
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Summary:A 65-year-old man was admitted to the hospital because of effort chest pain, 8 years after he received coronary artery bypass grafting [CABG: left internal thoracic artery (LITA) to left anterior descending artery (LAD), saphenous vein graft (SVG) to first diagonal branch (D1) and SVG to postero-lateral branch (PL)]. Emergent coronary angiography revealed right coronary artery occlusion with well patent bypass grafts. Percutaneus coronary intervention (PCI) was performed successfully, but 9 hours later, ventricular septal perforation (VSP) was occurred. Swan-Ganz catheter revealed that pulmonary to systemic blood flow ratio (Qp/Qs) was 2.6. In spite of intensive medical care, his hemodynamics was gradually exacerbated. Subsequent intracavitary repair with equine pericardial patch, sutured using interrupted mattress sutures with felt pledgets, was performed. He had an uneventful recovery thereafter, extubated and weaned from an intra-aortic balloon pumping at the 1st day. He was discharged from hospital on the 27th postoperative day.
ISSN:0021-5252