Abstract | OBJECTIVE: METHODS: Between January 2001 and December 2016, 42 patients were treated for left ventricular free wall rupture at Jichi Medical University. Of them, 35 consecutive patients undergoing sutureless repair using the TachoComb (CSL Behring, Tokyo, Japan) or TachoSil (Nycomed, Zurich, Switzerland) patches were included in this study. No patient required cardiopulmonary bypass. The oozing type of left ventricular free wall rupture was observed in 33 patients (94%), and the blow-out type was observed in 2 patients (6%). The rupture sites were the anterior wall in 16 patients (46%), the posterior-lateral wall in 11 patients (31%), and the inferior wall in 8 patients (23%). RESULTS: The in-hospital mortality rate was 17% (6 patients). Re- rupture after sutureless repair occurred in 17% (6 patients). Of them, 4 cases (67%) of re- rupture occurred within 24 hours after surgery. The 2 patients with blow-out type left ventricular free wall rupture experienced re- rupture. Three patients required mitral valve surgery after sutureless repair during the admission. The overall survivals at 1, 5, and 10 years were 71.4%, 68.6%, and 62.9%, respectively. Multivariable analysis revealed that re- rupture was an independent predictor for decreased survival (hazard ratio, 58.6; 95% confidence interval, 4.9-701.6; P = .001). Postoperative pseudoaneurysm formation was not detected during the follow-up. CONCLUSIONS:
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Authors | Homare Okamura, Naoyuki Kimura, Makiko Mieno, Harunobu Matsumoto, Koichi Yuri, Atsushi Yamaguchi |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 158
Issue 3
Pg. 771-777
(09 2019)
ISSN: 1097-685X [Electronic] United States |
PMID | 30878160
(Publication Type: Journal Article, Video-Audio Media)
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Copyright | Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Drug Combinations
- TachoSil
- tachocomb
- Fibrinogen
- Aprotinin
- Thrombin
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Topics |
- Aged
- Aged, 80 and over
- Aprotinin
(therapeutic use)
- Databases, Factual
- Drug Combinations
- Female
- Fibrinogen
(therapeutic use)
- Heart Rupture, Post-Infarction
(diagnostic imaging, mortality, physiopathology, surgery)
- Hospital Mortality
- Humans
- Japan
- Male
- Middle Aged
- Recurrence
- Reoperation
- Retrospective Studies
- Risk Factors
- Sutureless Surgical Procedures
(adverse effects, mortality)
- Thrombin
(therapeutic use)
- Time Factors
- Treatment Outcome
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