Sutureless repair and deep sedation for a blow-out type post-infarction
left ventricular free wall rupture
A 71-year-old woman who was resuscitated from cardiac arrest after
pericardial drainage, was admitted to our hospital. Enhanced computed
tomography demonstrated pericardial effusion due to rupture of posterior
ventricular myocardium. She underwent emergent surgical repair. A 20-mm
tear in the extensively necrotic left ventricular posterior wall and
active hemorrhage were identified. Sutureless repair using three sheets
of TachoSil (CSL Behring, Tokyo, Japan) and fibrin glue was performed.
To reduce ventricular pressure to avoid re-rupture and formation of
ventricular aneurysm, deep sedation was followed in the intensive care
unit for 2 weeks. The patient returned to her normal daily life and is
progressing well for more than 5 months after the surgery.