Post-infarction left ventricular free wall rupture: 12-years experience from the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague, Czech Republic

Background. Post-infarction left ventricular free wall rupture (LVFWR) is a feared and catastrophic complication of myocardial infarction that carries a high surgical and hospital mortality. Due to the rarity of this complication, little information exists on surgical treatment and outcomes. Goal an...

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Autores principales: Petr Kacer, Vera Adamkova, Jaroslav Alois Hubacek, Tereza Cervinkova, Vaclav Adamek, Ivana Kralova Lesna, Vera Lanska, Jan Pirk
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Publicado: Palacký University Olomouc, Faculty of Medicine and Dentistry 2021
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spelling oai:doaj.org-article:029727c02a2d466b812a3ea6167180be2021-11-29T09:17:21ZPost-infarction left ventricular free wall rupture: 12-years experience from the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague, Czech Republic1213-81181804-7521https://doaj.org/article/029727c02a2d466b812a3ea6167180be2021-11-01T00:00:00Zhttps://biomed.papers.upol.cz/artkey/bio-202104-0010_post-infarction-left-ventricular-free-wall-rupture-12-years-experience-from-the-cardiac-centre-of-the-institut.phphttps://doaj.org/toc/1213-8118https://doaj.org/toc/1804-7521Background. Post-infarction left ventricular free wall rupture (LVFWR) is a feared and catastrophic complication of myocardial infarction that carries a high surgical and hospital mortality. Due to the rarity of this complication, little information exists on surgical treatment and outcomes. Goal and Methods. The goal of this study was to present our experience with LVFWR. We present a retrospective cohort of 19 consecutive patients who were surgically treated in the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague between January 2006 and December 2017. Results. Thirty-day mortality was 26%. Five patients died. Four patients died in the operating theatre and one patient on the ninth postoperative day following re-rupture. Seventy-four percent of the patient cohort survived and were discharged from hospital. The median length of follow-up was 45 months (range 0.75-150). No patient died during follow-up. Median postoperative ejection fraction was 45% (range 25-65%). Angina pectoris and dyspnea were investigated during follow-up and graded according to the Canadian cardiology society (CCS) and the New York Heart Association (NYHA) classifications. Fourteen patients had CCS class I, eight patients had NYHA class I dyspnea and six patients had NYHA class II. Re-rupture occurred after hospital discharge in one patient one month after the original surgery. The patient was treated successfully by urgent surgical intervention. Conclusion. LVFWR is a catastrophic and challenging complication of myocardial infarction. Good outcomes can be achieved by rapid diagnosis and urgent surgical intervention as shown by our results.Petr KacerVera AdamkovaJaroslav Alois HubacekTereza CervinkovaVaclav AdamekIvana Kralova LesnaVera LanskaJan PirkPalacký University Olomouc, Faculty of Medicine and Dentistryarticleacute myocardial infarctionmyocardial ruptureventricular wallMedicineRENBiomedical Papers, Vol 165, Iss 4, Pp 408-415 (2021)
institution DOAJ
collection DOAJ
language EN
topic acute myocardial infarction
myocardial rupture
ventricular wall
Medicine
R
spellingShingle acute myocardial infarction
myocardial rupture
ventricular wall
Medicine
R
Petr Kacer
Vera Adamkova
Jaroslav Alois Hubacek
Tereza Cervinkova
Vaclav Adamek
Ivana Kralova Lesna
Vera Lanska
Jan Pirk
Post-infarction left ventricular free wall rupture: 12-years experience from the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague, Czech Republic
description Background. Post-infarction left ventricular free wall rupture (LVFWR) is a feared and catastrophic complication of myocardial infarction that carries a high surgical and hospital mortality. Due to the rarity of this complication, little information exists on surgical treatment and outcomes. Goal and Methods. The goal of this study was to present our experience with LVFWR. We present a retrospective cohort of 19 consecutive patients who were surgically treated in the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague between January 2006 and December 2017. Results. Thirty-day mortality was 26%. Five patients died. Four patients died in the operating theatre and one patient on the ninth postoperative day following re-rupture. Seventy-four percent of the patient cohort survived and were discharged from hospital. The median length of follow-up was 45 months (range 0.75-150). No patient died during follow-up. Median postoperative ejection fraction was 45% (range 25-65%). Angina pectoris and dyspnea were investigated during follow-up and graded according to the Canadian cardiology society (CCS) and the New York Heart Association (NYHA) classifications. Fourteen patients had CCS class I, eight patients had NYHA class I dyspnea and six patients had NYHA class II. Re-rupture occurred after hospital discharge in one patient one month after the original surgery. The patient was treated successfully by urgent surgical intervention. Conclusion. LVFWR is a catastrophic and challenging complication of myocardial infarction. Good outcomes can be achieved by rapid diagnosis and urgent surgical intervention as shown by our results.
format article
author Petr Kacer
Vera Adamkova
Jaroslav Alois Hubacek
Tereza Cervinkova
Vaclav Adamek
Ivana Kralova Lesna
Vera Lanska
Jan Pirk
author_facet Petr Kacer
Vera Adamkova
Jaroslav Alois Hubacek
Tereza Cervinkova
Vaclav Adamek
Ivana Kralova Lesna
Vera Lanska
Jan Pirk
author_sort Petr Kacer
title Post-infarction left ventricular free wall rupture: 12-years experience from the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague, Czech Republic
title_short Post-infarction left ventricular free wall rupture: 12-years experience from the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague, Czech Republic
title_full Post-infarction left ventricular free wall rupture: 12-years experience from the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague, Czech Republic
title_fullStr Post-infarction left ventricular free wall rupture: 12-years experience from the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague, Czech Republic
title_full_unstemmed Post-infarction left ventricular free wall rupture: 12-years experience from the Cardiac Centre of the Institute of Clinical and Experimental Medicine in Prague, Czech Republic
title_sort post-infarction left ventricular free wall rupture: 12-years experience from the cardiac centre of the institute of clinical and experimental medicine in prague, czech republic
publisher Palacký University Olomouc, Faculty of Medicine and Dentistry
publishDate 2021
url https://doaj.org/article/029727c02a2d466b812a3ea6167180be
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