The Surgical Significance of Myocardial Infarction

The surgical Implications of myocardial infarction are related to fibrosis or rupture involving the left ventricular wall, the interventricular septum or the mitral valve mechanism, and to obstructive coronary artery disease. The presence of these abnormalities can be detected by a full cardiac investigation, including catheterization and cineangiography. The surgical principles for the management of cardiac aneurysm, ventricular septal defect and papillary muscle or chordal rupture have been established; for the akinetic area principles are emerging, whilst for diffuse involvement of the left ventricular wall and massive infarction with cardiogenic shock management is still controversial. Saphenous vein bypass or interposition, combined when indicated with resection of an akinetic area or internal mammary implant, is each a valuable procedure in the management of coronary artery obstruction. Thrombectomy can prove life-saving in acute coronary thrombosis.