Intramyocardial Dissection following Postinfarction Ventricular Wall Rupture Contained by Surrounding Postoperative Adhesions
Introduction. Dissection of the myocardium is a rare form of cardiac rupture, caused by a hemorrhagic dissection among the spiral myocardial fibers, its diagnosis is rarely established before the operation or death, and extremely few cases have been reported in the literature and none of these cases...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-01-01
|
| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2015/584795 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832545783119872000 |
|---|---|
| author | Abdulkadir Ercan Orcun Gurbuz Gencehan Kumtepe Hakan Ozkan Ilker Hasan Karal Yusuf Velioglu Serdar Ener |
| author_facet | Abdulkadir Ercan Orcun Gurbuz Gencehan Kumtepe Hakan Ozkan Ilker Hasan Karal Yusuf Velioglu Serdar Ener |
| author_sort | Abdulkadir Ercan |
| collection | DOAJ |
| description | Introduction. Dissection of the myocardium is a rare form of cardiac rupture, caused by a hemorrhagic dissection among the spiral myocardial fibers, its diagnosis is rarely established before the operation or death, and extremely few cases have been reported in the literature and none of these cases seem to have a history of previous cardiac surgery which makes our report unique. Case Presentation. A 61-year-old female patient was admitted into the emergency room with complaints of progressive chest pain for 2 days. She had a history of second time prosthetic aortic valve replacement and was under anticoagulation therapy. She was diagnosed with an acute inferoposterior myocardial infarction and underwent emergency coronary angiography revealing spontaneous recanalization of the right coronary artery. During the follow-up, she developed cardiogenic shock and a new occurring systolic ejection murmur. Transthoracic echocardiography showed a left ventricular free wall rupture; then, she was taken in for emergency surgery. During the operation, a rupture zone and a wide intramyocardial dissecting area were detected. Intraventricular patch repair technic with autologous pericardial patch was used to exclude the ruptured area. Following the warming period, despite adequate hemostasis, hemorrhage around suture lines progressively increased, leading to the patient’s death. Conclusion. Pericardial adhesions might contain left ventricular rupture leading to intramyocardial dissection. |
| format | Article |
| id | doaj-art-59b0120fc9f74ee7a291755a86690b9d |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-59b0120fc9f74ee7a291755a86690b9d2025-02-03T07:24:44ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/584795584795Intramyocardial Dissection following Postinfarction Ventricular Wall Rupture Contained by Surrounding Postoperative AdhesionsAbdulkadir Ercan0Orcun Gurbuz1Gencehan Kumtepe2Hakan Ozkan3Ilker Hasan Karal4Yusuf Velioglu5Serdar Ener6Department of Cardiovascular Surgery, Balıkesir University Medical Faculty, Bigadiç, 10145 Balıkesir, TurkeyDepartment of Cardiovascular Surgery, Balıkesir University Medical Faculty, Bigadiç, 10145 Balıkesir, TurkeyDepartment of Cardiovascular Surgery, Balıkesir University Medical Faculty, Bigadiç, 10145 Balıkesir, TurkeyDepartment of Cardiology, Bahçeşehir University Faculty of Medicine, Istanbul, TurkeyDepartment of Cardiovascular Surgery, Samsun Hospital for Education and Research, İlkadım, 55090 Samsun, TurkeyDepartment of Cardiovascular Surgery, Medical Park Uşak Hospitals, Uşak, TurkeyDepartment of Cardiovascular Surgery, Acıbadem Bursa Hospital, Bursa, TurkeyIntroduction. Dissection of the myocardium is a rare form of cardiac rupture, caused by a hemorrhagic dissection among the spiral myocardial fibers, its diagnosis is rarely established before the operation or death, and extremely few cases have been reported in the literature and none of these cases seem to have a history of previous cardiac surgery which makes our report unique. Case Presentation. A 61-year-old female patient was admitted into the emergency room with complaints of progressive chest pain for 2 days. She had a history of second time prosthetic aortic valve replacement and was under anticoagulation therapy. She was diagnosed with an acute inferoposterior myocardial infarction and underwent emergency coronary angiography revealing spontaneous recanalization of the right coronary artery. During the follow-up, she developed cardiogenic shock and a new occurring systolic ejection murmur. Transthoracic echocardiography showed a left ventricular free wall rupture; then, she was taken in for emergency surgery. During the operation, a rupture zone and a wide intramyocardial dissecting area were detected. Intraventricular patch repair technic with autologous pericardial patch was used to exclude the ruptured area. Following the warming period, despite adequate hemostasis, hemorrhage around suture lines progressively increased, leading to the patient’s death. Conclusion. Pericardial adhesions might contain left ventricular rupture leading to intramyocardial dissection.http://dx.doi.org/10.1155/2015/584795 |
| spellingShingle | Abdulkadir Ercan Orcun Gurbuz Gencehan Kumtepe Hakan Ozkan Ilker Hasan Karal Yusuf Velioglu Serdar Ener Intramyocardial Dissection following Postinfarction Ventricular Wall Rupture Contained by Surrounding Postoperative Adhesions Case Reports in Surgery |
| title | Intramyocardial Dissection following Postinfarction Ventricular Wall Rupture Contained by Surrounding Postoperative Adhesions |
| title_full | Intramyocardial Dissection following Postinfarction Ventricular Wall Rupture Contained by Surrounding Postoperative Adhesions |
| title_fullStr | Intramyocardial Dissection following Postinfarction Ventricular Wall Rupture Contained by Surrounding Postoperative Adhesions |
| title_full_unstemmed | Intramyocardial Dissection following Postinfarction Ventricular Wall Rupture Contained by Surrounding Postoperative Adhesions |
| title_short | Intramyocardial Dissection following Postinfarction Ventricular Wall Rupture Contained by Surrounding Postoperative Adhesions |
| title_sort | intramyocardial dissection following postinfarction ventricular wall rupture contained by surrounding postoperative adhesions |
| url | http://dx.doi.org/10.1155/2015/584795 |
| work_keys_str_mv | AT abdulkadirercan intramyocardialdissectionfollowingpostinfarctionventricularwallrupturecontainedbysurroundingpostoperativeadhesions AT orcungurbuz intramyocardialdissectionfollowingpostinfarctionventricularwallrupturecontainedbysurroundingpostoperativeadhesions AT gencehankumtepe intramyocardialdissectionfollowingpostinfarctionventricularwallrupturecontainedbysurroundingpostoperativeadhesions AT hakanozkan intramyocardialdissectionfollowingpostinfarctionventricularwallrupturecontainedbysurroundingpostoperativeadhesions AT ilkerhasankaral intramyocardialdissectionfollowingpostinfarctionventricularwallrupturecontainedbysurroundingpostoperativeadhesions AT yusufvelioglu intramyocardialdissectionfollowingpostinfarctionventricularwallrupturecontainedbysurroundingpostoperativeadhesions AT serdarener intramyocardialdissectionfollowingpostinfarctionventricularwallrupturecontainedbysurroundingpostoperativeadhesions |