scholarly journals LEFT VENTRICULAR PSEUDOANEURYSM - A COMPLICATION OF ACUTE MYOCARDIAL INFARCTION

2021 ◽  
Author(s):  
Adnaldo Maia ◽  
Rafael Tajra ◽  
Adrian Rivadeneira ◽  
Iuri António ◽  
Antônio de Almeida
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Artery Bypass ◽  
Signs And Symptoms ◽  
Left Ventricular ◽  
Apical Region ◽  
Inferior Wall ◽  
Bypass Grafting ◽  
Left Ventricular Pseudoaneurysm ◽  
Polypropylene Sutures

Left ventricular pseudoaneurysm is a complication of acute myocardial infarction, especially after involvement of the inferior wall. The signs and symptoms are nonspecific. We report a case of a 69-year-old patient admitted for clinically important dyspnea. Transthoracic echocardiography showed pseudoaneurysm in the apical region, measuring 96x116 mm. Surgical correction was performed, using bovine pericardium and anchoring the ventricular orifice with 3-0 polypropylene sutures. It was not possible to perform coronary artery bypass grafting, as the distal beds of the proposed vessels were calcified. The patient was referred to the intensive care unit and discharged on the 17th postoperative day.

Impella-assisted coronary artery bypass grafting for acute myocardial infarction

2019 ◽  
Vol 28 (2) ◽  
pp. 115-117
Author(s):  
Kenichiro Takahashi ◽  
Jun Nakata ◽  
Jiro Kurita ◽  
Yosuke Ishii ◽  
Wataru Shimizu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
First Case

We report two cases of Impella-assisted coronary artery bypass grafting for acute myocardial infarction with cardiogenic shock. The first case involved coronary artery bypass grafting and mitral valve replacement, and the second involved off-pump coronary artery bypass grafting. Emergent Impella-assisted coronary artery bypass grafting was successfully performed in both cases. Our findings highlight the ability of Impella percutaneous left ventricular assist device to provide excellent hemodynamic support during the entire perioperative period.

Treatment of Acute Myocardial Infarction with Cardiogenic Shock using Left Ventricular Assist Device

1989 ◽  
Vol 12 (3) ◽  
pp. 175-179 ◽  
Author(s):  
H. Noda ◽  
H. Takano ◽  
Y. Taenaka ◽  
T. Nakatani ◽  
M. Umezu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Multiple Organ ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Assist Device ◽  
Ventricular Assist ◽  
The Third ◽  
Left Ventricular Assist

We have treated ten cardiogenic shock patients after acute myocardial infarction (AMI) with a left ventricular assist device (LVAD). These patients were later divided into three groups: the first group with ventricular septal perforation, the second with aorto-coronary bypass grafting (ACBG) before LVAD implantation and the third group without ACBG. LVAD maintained the systemic circulation in each group, and cardiac function recovered enough to remove LVAD in 70% of the total patients. Two of three patients in the first group were discharged from hospital. Two weaned cases in the second group died of multiple organ failure and one was discharged, and hemorrhagic necrosis was seen in the bypassed area of the myocardium. One patient of the third group could not be weaned from LVAD because of respiratory failure though his heart function began to recover. Another case in the third group underwent bypass grafting after removal of LVAD. However ACBG surgery should be done very carefully because a patient in shock is occasionally intolerant to major surgery. In all groups, the major cause of death was multiple organ failure which was probably caused by the prolonged low output condition prior to LVAD application. In the light of this experience, it appears that LVAD should be applied before irreversible damage occurs to major organs, including the heart itself. To ensure the timely application of LVAD, some way must be found to introduce systematic application of LVAD into the normal course of AMI treatment.

scholarly journals Conservative Management of Subacute Contained Left Ventricular Rupture after Acute Myocardial Infarction

2018 ◽  
Vol 03 (01) ◽  
pp. 034-038
Author(s):  
Bharat Goud C ◽  
Johann Christopher
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Color Doppler ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Mechanical Complication ◽  
Inferior Wall ◽  
Early Reperfusion ◽  
St Segment Elevation ◽  
Myocardial Wall

AbstractLeft ventricular free wall rupture (LVFWR) is a near-fatal mechanical complication of acute myocardial infarction in which an early diagnosis and emergency surgery should be of utmost priority for successful treatment. LVFWR is generally perceived to be universally fatal. Majority of LVFWR patients developing cardiac tamponade die rapidly, while in minority of cases the development of tamponade may be sufficiently slow to allow for diagnosis and successful intervention. In this article, the authors report a case of a 63-year-old male patient diagnosed with an inferoposterior wall myocardial infarction treated with early reperfusion thrombolytic therapy presenting 3 days later with diagnosis of subacute LVFWR. Patient had a history of relapse of chest pain which was severe and prolonged with 2 to 3 mm saddle-shaped ST-segment elevation in lateral leads, detected on a routine electrocardiogram, which led to an urgent bedside transthoracic echocardiogram (TTE). TTE showed regional wall motion abnormality in form of akinetic basal inferior-wall, a small echodense pericardial effusion, and a canalicular tract from endocardium to pericardium, through which color-Doppler examination suggested blood crossing the myocardial wall. A cardiac magnetic resonance imaging further reinforced the possibility of contained LVFWR.

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