Ventricular septal rupture and right ventricular free wall rupture after acute myocardial infarction

• Published in: Kyobu geka. The Japanese journal of thoracic surgery Vol. 66; no. 9; p. 810
• Main Authors: Masaki, Naoki, Fukasawa, Manabu, Toyama, Shuji, Kawahara, Yu, Inage, Yuichi
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.08.2013
• Subjects: Aged; Cardiac Surgical Procedures - methods; Female; Heart Failure - etiology; Heart Rupture - etiology; Heart Rupture - surgery; Humans; Myocardial Infarction - complications; Suture Techniques; Treatment Outcome; Ventricular Septal Rupture - etiology; Ventricular Septal Rupture - surgery
• ISSN: 0021-5252

Cardiac rupture is a catastrophic complication of acute myocardial infarction with highly mortality rate. Three types of rupture are ventricular free wall rupture( VFR), ventricular septal rupture( VSR), and papillary muscle rupture( PMR). A combination of any 2 types of rupture is called ventricular double rupture (VDR), and very rare. We report a case of VDR (VSR and VFR) after acute myocardial infarction. A 76-year-old female with heart failure was admitted to our hospital. Echocardiography showed an apical VSR and pericardial effusion. She was diagnosed with VDR and emergent operation was performed. During operation, the site of VFR was right ventricle, which was the same infarction area of VSR. VSR was closed by infarction exclusion technique, concurrently excluding the site of VFR. VFR was successfully repaired by mattress sutures. Post-operative course was good without heart failure, though residual shunt was remained. The patient survived and was discharged from our hospital.