Wm. Park et al., Successful repair of myocardial free wall rupture after thrombolytic therapy for acute infarction, ANN THORAC, 70(4), 2000, pp. 1345-1349
Citations number
28
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. Controversy exists regarding the timing of thrombolytic adminis
tration and rupture rate.
Methods. Hospital records at St. Luke's-Roosevelt Hospital of the 4 study p
atients were reviewed and compared with those of 41 patients from a group o
f 537 patients concurrently admitted with a diagnosis of myocardial infarct
ion (MI).
Results. Four patients experienced ventricular free wall rupture after havi
ng a MI between November 17, 1993, and July 28, 1995. All received tissue p
lasminogen activator. In 1 patient, pericardial effusion associated with a
pseudoaneurysm was discovered in the operating room. The 3 others developed
clinical pericardial tamponade before surgery. All 4 patients survived and
left the hospital on postoperative days 10, 11, 11, and 82, respectively.
During this same time period, 537 patients were admitted with MI, 41 of who
m died; the study's 4 patients were compared with these 41.
Conclusions. These data demonstrate that rupture of the ventricular free wa
ll can occur early after thrombolytic therapy and may have a subacute cours
e. Prompt diagnosis and surgery offer excellent chances of surviving this f
atal condition. (C) 2000 by The Society of Thoracic Surgeons.