Key result
Direct myocardial suture with revascularization successfully manages self-repaired postinfarction ventricular wall rupture.
Why the study?
Left ventricular free wall rupture after myocardial infarction is often fatal due to late diagnosis or complicated emergency surgery, and rare cases of self-repair have unique pathological features.
Case Report (n=1)
This case report describes a rare instance of self-repair of a postinfarction left ventricular free wall rupture that presented as monoventricular constrictive pericarditis and was successfully treated surgically.
Rare self-repair after post-MI LV rupture possible; leaves open conservative strategies in stable patients pending prospective data.
Left ventricular free wall rupture is a known complication of myocardial infarction. It is often fatal because of late diagnosis or complicated emergency surgical procedure. We here describe a rare case of self-repair of a posterior wall rupture following left circumflex artery acute occlusion with unique pathological findings. The patient came to our observation two months later the acute episode. The lesion was self-repaired by the formation of a thin-layered pseudoaneurysm and a crescent-like, thick-capsulated haematoma surrounding the whole left ventricle. The haematoma severely impaired left ventricular function acting like a monoventricular constrictive pericarditis. The patient underwent successful surgical procedure of direct suture of the myocardial tear associated to coronary artery revascularization. “Wheresoever you go, go with all your heart” Confucius
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A 2006 study conducted a case report in Postinfarction Ventricular Wall Rupture (n=1). Direct suture of the myocardial tear and coronary artery revascularization was evaluated. Direct suture of the myocardial tear and coronary artery revascularization successfully treated a rare case of self-repaired postinfarction ventricular wall rupture.
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