Surgical treatment for complications of acute myocardial infarction

Okada, Haruhiko; Nishida, Masahiko; Murakami, Masanori; Hamano, Kimikazu

doi:10.1007/s11748-005-0004-z

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…The study selection process and reasons for exclusion are described in Figure S1 . After removal of articles not pertinent to the design of the current study, 11 reports 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 with suitable data were included in the final meta‐analysis. All selected papers were published after 2001.…”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of surgical treatment for postinfarction left ventricular free‐wall rupture

Matteucci

Formica

Kowalewski

et al. 2021

Journal of Cardiac Surgery

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Background Left ventricular free‐wall rupture (LVFWR) is one of the most lethal complications after acute myocardial infarction (AMI). The optimal therapeutic strategy is controversial. The current meta‐analysis sought to examine the outcome of patients surgically treated for post‐AMI LVFWR. Methods A comprehensive literature review was performed to identify articles reporting outcomes of subjects who underwent LVFWR surgical repair. The primary endpoint was operative mortality. A meta‐analysis was performed to assess the associations of predefined variables of interest and clinical prognosis. Results Of the 3132 retrieved articles, 11 nonrandomized studies, enrolling a total of 363 patients, fulfilled the inclusion criteria and were included in this analysis. The mean age of patients was 68 years. The operative mortality rate was 32% (n = 115). Meta‐analysis revealed reduced operative risk in patients with oozing type rupture, as compared to blowout type (risk ratios [RR]: 0.47; 95% confidence interval [CI]: 0.33–0.67; p < .0001); RR was also significantly reduced in subjects in whom LVFWR was treated with sutureless technique, as compared to those undergoing sutured repair (RR: 0.59; 95% CI: 0.41–0.83; p = .002). Increased risk of operative mortality was demonstrated in patients who required postoperative extracorporeal membrane oxygenation (ECMO) support (RR: 2.39; 95% CI: 1.59–3.60; p < .0001). Conclusions Surgical treatment of postinfarction LVFWR has a high operative mortality rate. Blowout rupture, sutured repair and postoperative ECMO support are factors associated with increased risk of operative mortality.

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Section: Resultsmentioning

confidence: 99%

Meta‐analysis of surgical treatment for postinfarction left ventricular free‐wall rupture

Matteucci

Formica

Kowalewski

et al. 2021

Journal of Cardiac Surgery

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Intraoperative coronary angiography in postinfarction ventricular free wall rupture: how technology can change diagnostic and therapeutic timing

D’Onofrio

Abbiate

Magagna

et al. 2008

Interactive CardioVascular and Thoracic Surgery

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Left ventricular free wall rupture often presents with an abrupt onset and rapidly progresses towards cardiogenic shock or electromechanical dissociation. The diagnostic pathway is still a matter of debate: echocardiography is commonly decisive but the assessment of coronary artery status is essential in order to optimize the surgical procedure. However, a preoperative coronary angiography could generate a dramatic delay of surgery. We report a case of a patient with a post-infarction left ventricular free wall rupture presenting with cardiac tamponade and cardiogenic shock who underwent emergency surgery. After cardiopulmonary bypass institution, an intraoperative coronary angiography was performed. Successful repair of the ventricular free wall rupture associated with a well-targeted surgical myocardial revascularization were carried out. This case illustrates how the development of technologically advanced hybrid operating rooms could lead to a new diagnostic and therapeutic approach to this potentially fatal complication.

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eComment: Role of the future cardiac surgeon

Benetti¹

2008

Interactive CardioVascular and Thoracic Surgery

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Surgical treatment for complications of acute myocardial infarction

Abstract: The operative prognosis of blowout cardiac rupture was poor. Good results were obtained with the infarct exclusion technique for patients with VSP. Although some patients had postoperative residual shunts, the infarct exclusion technique was generally a safe and excellent procedure.

Cited by 4 publications

References 10 publications

Meta‐analysis of surgical treatment for postinfarction left ventricular free‐wall rupture

Meta‐analysis of surgical treatment for postinfarction left ventricular free‐wall rupture

Intraoperative coronary angiography in postinfarction ventricular free wall rupture: how technology can change diagnostic and therapeutic timing

eComment: Role of the future cardiac surgeon

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