Key result
Off-pump sutureless repair for LV free wall rupture carries a ~14% pseudoaneurysm rate.
Why the study?
Clinical results of ischemic left ventricular free-wall rupture show high mortality rates and optimal repair techniques need evaluation.
Does off-pump sutureless repair improve clinical outcomes in patients with ischemic left ventricular free-wall rupture?
Systematic Review (n=35)
Does off-pump sutureless repair improve clinical outcomes in patients with ischemic left ventricular free-wall rupture?
Off-pump sutureless repair using fibrin glue is a promising strategy for ischemic left ventricular free-wall rupture, though serial echocardiography is mandatory to monitor for pseudoaneurysm formation.
Sutureless fibrin glue repair may be considered for LV free-wall rupture; extends limited evidence while cautioning on blowout-type limitations and pseudoaneurysm risk.
BACKGROUND: Clinical results of ischemic left ventricular free-wall rupture show high mortality rates. METHODS: We reviewed studies published after 1993 on PubMed. RESULTS: A sutureless technique using fibrin glue sheets or patches with/without fibrin glue might contribute to improved clinical results. However, some technique limitations remain for blowout-type ruptures, and the possibility of a pseudoaneurysm formation at the repair site after surgery should be considered. CONCLUSIONS: The sutureless technique can be a promising strategy for the treatment of ischemic rupture, but serial echocardiographic studies should be mandatory for diagnosing a left ventricular pseudoaneurysm formation thereafter.
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Yoshio Misawa (2017) conducted a systematic review in Ischemic left ventricular free wall rupture (n=35). Off-pump sutureless repair was evaluated on Incidence of left ventricular pseudoaneurysm formation. Off-pump sutureless repair for ischemic left ventricular free wall rupture is a promising strategy, but is associated with a 14.3% incidence of left ventricular pseudoaneurysm formation.
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