Mechanical complications of myocardial infarction: basic aspects of pathogenesis and approaches to surgical treatment

Ischemic heart disease is a leading cause of mortality of the adult population. The most mortality of all forms of ischemic heart disease is occurred with development of myocardial infarction. Meanwhile, the direct cause of death are complications of myocardial infarction. Since the advent of catheter-based and surgical reperfusion, there has been a significant decrease in the frequency of these complications. However, patients with large myocardial infarctions or those who do not receive necessary revascularization in time remain at risk of mechanical complications of acute myocardial infarction. The most common mechanical complications are rupture of the papillary muscles of the mitral valve and acute mitral regurgitation, interventricular septal defect, forming of aneurysms and pseudoaneurysms, and free-wall rupture. Although these complications are rare, their prognosis is unfavourable and is associated with high mortality at the prehospital and hospital stage. Early diagnosis, determination of optimal treatment tactics are crucial for increasing the survival rate of patients.