scholarly journals Surgical treatment of mechanical complications following acute myocardial infarction. A Case Series.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Jorgjia Bucaj ◽  
Edvin Prifti
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Surgery ◽  
Papillary Muscle ◽  
Medical Centre ◽  
Main Body ◽  
Ventricular Septal Rupture ◽  
Papillary Muscle Rupture ◽  
Mechanical Complications ◽  
Muscle Rupture

Background: Acute myocardial infarction can result in ischemic, mechanical, arrhythmic, embolic or inflammatory complications. Despite high operative mortality, the lack of an effective and immediate medical alternative makes the surgery repair the mainstay of current management for these patients. Novel surgical approaches are presented to manage these complications. Main body: Mechanical complications presented at the Department of Cardiac Surgery-Tirana University Medical Centre consisted in nine cases during the period January 2008-June 2018: two anterolateral papillary muscle rupture cases (22%), one posteromedial papillary muscle rupture case (11%), two ventricular septal rupture cases (22%),  one free ventricle wall rupture case (11%),  three chordae tendineae rupture cases (33%), four out of nine patients (44,5%) underwent concomitant CABG intervention. Intra operator mortality is estimated 11% (one out of nine cases). The Department of Cardiac Surgery-Tirana University Medical Centre is limited only in open surgery techniques for repair the post myocardial infarction mechanical complications. To our personal view key reasons for these results are conditioned from lack of medical devices, trained stuff, reliable short and long outcome data from alternative procedures in order to incorporate thus in our daily practice. Further studies should be undertaken not only to create a precise image of the situation, but also to evaluate the results of the possible changes.  Key words: Acute myocardial infarction, mechanical complications, papillary muscle rupture, ventricular septal rupture, free ventricle wall rupture, CABG intervention.

scholarly journals Papillary Muscle Rupture Complicating Acute Myocardial Infarction

2020 ◽  
Vol 2 (15) ◽  
pp. 2283-2288
Author(s):  
Lyana Labrada ◽  
Aadhar Patil ◽  
Jeevan Kumar ◽  
Samuel Kolman ◽  
Omer Iftikhar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Papillary Muscle ◽  
Papillary Muscle Rupture ◽  
Muscle Rupture

Multiplane Transesophageal Echocardiographic Description of a Complete Papillary Muscle Rupture during Acute Myocardial Infarction

1996 ◽  
Vol 4 (1) ◽  
pp. 60-62
Author(s):  
Ha Jong Won ◽  
Namsik Chung ◽  
Cho Seung Yun ◽  
Shim Won Heum ◽  
Kang Meyun Sik ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Transesophageal Echocardiography ◽  
Papillary Muscle ◽  
Rare Complication ◽  
Papillary Muscle Rupture ◽  
Complete Rupture ◽  
Muscle Rupture ◽  
Q Wave

The complete rupture of a papillary muscle is a relatively rare complication of acute myocardial infarction and is generally considered to be rapidly fatal. We describe the multiplane transesophageal echocardiography features of a completely ruptured anterolateral papillary muscle complicating acute non-Q wave lateral myocardial infarction.

Mechanical complications of myocardial infarction

2018 ◽  
Author(s):  
José López-Sendón ◽  
Esteban López de Sá
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Papillary Muscle ◽  
Thrombus Formation ◽  
Left Ventricular ◽  
Free Wall ◽  
Papillary Muscle Rupture ◽  
Mechanical Complications ◽  
Muscle Rupture

Mechanical complications after an acute infarction involve different forms of heart rupture, including free wall rupture, interventricular septal rupture, and papillary muscle rupture. Its incidence decreased dramatically with the widespread use of reperfusion therapies occurring in <1% of ST-elevation myocardial infarction patients, and mortality is very high if not properly diagnosed, as surgery is the only effective treatment (Ibanez et al, 2017). Echocardiography is the most important tool for diagnosis that should be suspected in patients with hypotension, heart failure, or recurrent chest pain. Awareness and well-established protocols are crucial for an early diagnosis. Modern imaging techniques permit a more reliable and direct identification of left ventricular free wall rupture, which is almost impossible to identify with conventional echocardiography. Mitral regurgitation, secondary to papillary muscle ischaemia or necrosis or left ventricular dilatation and remodelling, without papillary muscle rupture, is frequent after myocardial infarction and is considered as an independent risk factor for outcomes. Revascularization to control ischaemia and surgical repair should be considered in all patients with severe or symptomatic mitral regurgitation in the absence of severe left ventricular dysfunction. Other mechanical complications include true aneurysms and thrombus formation in the left ventricle. Again, these complications have decreased with the use of early reperfusion therapies and, for thrombus formation, with aggressive antithrombotic treatment. In a single large randomized trial (STICH), surgical remodelling of the left ventricle failed to demonstrate a significant improvement in outcomes, although it still may be an option in selected patients.

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