Key result
Emergent repair of post-MI ventricular double rupture with pericardial and Dacron patches yields favorable outcomes.
Why the study?
Mortality from mechanical complications of myocardial infarction remains high, and ventricular double rupture is a particularly rare and fatal complication requiring prompt Heart Team intervention.
Case Report (n=1)
No
A multidisciplinary approach involving prompt echocardiographic diagnosis, emergent surgical repair, and mechanical circulatory support can yield favorable outcomes in patients with highly fatal ventricular double rupture following myocardial infarction.
Answers are grounded in this paper and cite their sources.
Supports Heart Team evaluation for suspected post-MI ventricular double rupture; case report leaves optimal timing and outcomes open.
The frequency of mechanical complications related to transmural myocardial infarction (MI) has decreased due to the widespread implementation of reperfusion therapies. However, mortality related to these complications remains high, requiring prompt intervention by a Heart Team. Ventricular double rupture (VDR) is a particularly rare and fatal MI complication. A 58-year-old female patient presenting with 3 days of chest pain was diagnosed with ST-elevation MI. She underwent primary percutaneous coronary intervention of the left anterior descending artery. Transthoracic echocardiogram revealed an apical ventricular septum rupture and a mild pericardial effusion suggestive of free wall rupture. Emergent surgical repair included ventricular septal defect closure with a heterologous pericardial patch and repair of the free wall rupture with Dacron patch placement. Perioperative intraaortic balloon pump support was utilized. The patient had a favorable clinical course and was asymptomatic at her cardiology follow-up. VDR is the combination of two types of mechanical complications of MI. High clinical suspicion is necessary in hemodynamically unstable patients and those with risk factors for myocardial rupture, warranting echocardiographic evaluation for its diagnosis and characterization. Treatment of VDR is primarily surgical and may involve mechanical circulatory support (MCS). Despite advances in reperfusion therapies and surgical techniques, the prognosis of VDR remains poor. Our patient had a favorable outcome highlighting the importance of a multidisciplinary approach.
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Calderón-Miranda et al. (2025) conducted a case report in Ventricular double rupture following myocardial infarction (n=1). Surgical repair with heterologous pericardial patch and Dacron patch was evaluated on Clinical outcome. Emergent surgical repair of a ventricular double rupture following myocardial infarction using a heterologous pericardial patch and Dacron patch resulted in a favorable clinical outcome.
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