Successful management of left ventricular high lateral wall rupture during bentall procedure: a case report

Left ventricular rupture is a highly fatal complication, with reported in-hospital mortality rates as high as 80%, largely due to the challenge of achieving timely surgical intervention. We present the case of a 59-year-old female who underwent a Bentall procedure for moderate-to-severe aortic regurgitation with concomitant aortic sinus and ascending aortic dilation. Shortly after weaning from cardiopulmonary bypass, a sudden rupture of the high lateral left ventricular wall occurred. Successful management involved a combined intracardiac and extracardiac repair: the external tear was first exposed, followed by exploration to identify and suture the corresponding internal defect. Over a 4-year postoperative follow-up, the patient maintained good cardiac function with no cardiac-related mortality. This case highlights the critical therapeutic significance of combined intracardiac and extracardiac repair for left ventricular rupture and underscores key technical lessons for managing this catastrophic event.