Short-term and mid-term follow-up of sutureless surgery for postinfarction subacute free wall rupture

Abstract

We report our short-term and mid-term results with sutureless repair of postinfarction subacute left ventricular free wall rupture (LVFWR). For this purpose, we evaluated the short-term and mid-term postoperative results assessed by clinical examination and echocardiography of all patients who underwent surgery for subacute LVFWR between January 2004 and January 2009. Twenty-one patients were operated. Direct suture repair of LVFWR was carried out in only one patient. In all other cases we used a pericardial patch with biological glue. Early mortality was 19% (n=4). The median duration of follow-up was 17.3 months (interquartile range, 5-38.7), with a 13-month survival of 76%. Follow-up echocardiography showed no constriction associated with the rupture zone in any patient. According to our early experience, sutureless LVFWR repair is safe, effective and reproducible, and offers acceptable morbidity and mortality during follow-up.

Vascular anastomosis using controlled phase transitions in poloxamer gels

“…After precise approximation of the intimal layer of the vessel, we applied 2-octylcyanoacrylate in a circumferential manner to complete the anastomosis (n = 30). We used 2-octylcyanoacrylate because of its documented safety profile and its applications in other animal and human studies, which have demonstrated rapid polymerization, predictable absorption and no residual toxicity [30][31][32] .…”

Repair of post-infarction ventricular free wall rupture with TachoSil®

“…Since the first case report of successful treatment of post-infarction cardiac rupture with a sutureless technique in 1988, many alternatives have been described in the literature to cover myocardial perforations, including Teflon, Dacron, Gore-Tex or pericardial patches and different biological glues ( 1 ). The introduction of sutureless techniques for LVFWR repair corresponded with a great decrease in operative mortality rates ( 2 ).…”

Idiopathic Left Ventricular Rupture in the Absence of Coronary Artery Disease

“…The authors reported excellent results using the sutureless technique in 13 patients . Dacron, Gore‐Tex patch, autologous or heterologous bovine pericardium patch, and other type of patches have been used for the sutureless technique . The operative mortality associated with this procedure is 15.6% to 23.5% and the causes of early death included intractable cardiogenic shock, rerupture, reinfarction, and pneumonia.…”

“…Dacron, Gore‐Tex patch, autologous or heterologous bovine pericardium patch, and other type of patches have been used for the sutureless technique . The operative mortality associated with this procedure is 15.6% to 23.5% and the causes of early death included intractable cardiogenic shock, rerupture, reinfarction, and pneumonia. The five‐year survival was 61.1% to 74% and the causes of later death included acute myocardial infarction, cerebral infarction, and pneumonia.…”