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(Chest. 1972;61:10-13.)
© 1972 American College of Chest Physicians

III. Attempts at Emergency Surgical Treatment

B. Löfström M.D.1; L. Mogensen M.D.2; O. Nyquist M.D.2; E. Orinius M.D.2; A. Sjögren M.D.2; and B. Werner M.D.3

1 Department of Anesthesiology, Karolinska Institutet at Serafimerlasarettet, Stockholm, Sweden
2 Department of Medicine, Karolinska Institutet at Serafimerlasarettet, Stockholm, Sweden
3 Department of Surgery, Karolinska Institutet at Serafimerlasarettet, Stockholm, Sweden

The constant observation of patients in coronary care units (CCUs) permits a rapid diagnosis of rupture of the free left ventricular wall and resulting cardiac tamponade. This has allowed for a surgical trial in three patients to relieve the tamponade and to repair the rupture. No patients survived hospitalization. One patient died of a new rupture six hours after successful repair of the original one. The next patient survived for one month but suffered from severe brain damage as a consequence of excessive bleeding during the intervention. The third patient died during the attempts of suturing a new rupture of the myocardium, three hours after the first rupture. The experience shows that a CCU staff can 1) quickly and correctly diagnose a rupture with tamponade, 2) relieve the tamponade and 3) stop the gross bleeding. The main problem does not seem to be to prevent the myocardial sutures from cutting but rather the occurrence of new ruptures. Further attempts with varying techniques seem justified.




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Home page
 Asian Cardiovasc. Thorac. Ann.Home page
C. E Nwogu, J. M Moran, R. M Becker, and A T. Pezzella
Surgical Approach to Myocardial Rupture After Acute Myocardial Infarction
Asian Cardiovasc Thorac Ann, June 1, 1998; 6(2): 108 - 114.
[Abstract] [Full Text] [PDF]


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