Surgical Treatment of Acute Myocardial Infarction (AMI) Complicated by Septal Rupture (VSR)

Abstract

The case material consists of 16 patients, 11 men and 5 women, with a mean age of 60 Years, suffering manifest shock or preshock from AMI, complicated 1–28 days (average, 9 days) later by VSR. Preoperative IABP was necessary in 11 patients. All were studied by right heart catheterization, left ventricular angiography, and selective coronary angiography. Eleven patients had extensive anteroseptal and five inferior septal AMI with extensive infarction of the right ventricle. All were operated on in the acute stage and had resection of AMI and patch closure of VSR with a special technique. In addition eight patients had 16 aortocoronary bypasses. Fifteen patients needed postoperative IABP for 2–10 days. Ten of the anteroseptal AMI patients survived the operation and eight of these are long-term survivors. All the inferior septal AMI patients died in the postoperative period due to multiple organ failure from irreversible cardiogenic shock. The hemodynamic studies show normalization of all parameters and all survivors enjoy a normal life.