Postinfarction ventricular free-wall rupture is a rare mechanical complication (<0.01% to 0.02% of cases) requiring early recognition and emergent surgical or percutaneous repair.
This review highlights contemporary advancements in the diagnosis and treatment of post-MI ventricular free-wall rupture and pseudoaneurysm, including emerging transcatheter therapies for high-risk patients.
Postinfarction ventricular free-wall rupture is a rare mechanical complication, accounting for <0.01% to 0.02% of cases. As an often-catastrophic event, death typically ensues within minutes due to sudden massive hemopericardium resulting in cardiac tamponade. Early recognition is pivotal, and may allow for pericardial drainage and open surgical repair as the only emergent life-saving procedure. In cases of contained rupture with pseudo-aneurysm (PSA) formation, hospitalization with subsequent early surgical intervention is warranted. Not uncommonly, PSA may go unrecognized in asymptomatic patients and diagnosed late during subsequent cardiac imaging. In these patients, the unsettling risk of complete rupture demands early surgical repair. Novel developments, in the field of transcatheter-based therapies and multimodality imaging, have enabled percutaneous PSA repair as a feasible alternate strategy for patients at high or prohibitive surgical risk. Contemporary advancements in the diagnosis and treatment of postmyocardial infarction ventricular free-wall rupture and PSA are provided in this review.
Lorusso et al. (Wed,) conducted a review in Postinfarction ventricular free-wall rupture and pseudoaneurysm. Surgical and percutaneous repair was evaluated. Postinfarction ventricular free-wall rupture is a rare mechanical complication (<0.01% to 0.02% of cases) requiring early recognition and emergent surgical or percutaneous repair.