Treatment experience of cardiac rupture in patients with acute myocardial infarction
10.3760/cma.j.issn.0253-3758.2018.07.009
- VernacularTitle: 急性心肌梗死后心脏破裂的治疗体会
- Author:
Jiaxin YE
1
;
Min GE
;
Dongjin WANG
Author Information
1. Department of Cardio-thoracic Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Heart rupture;
Treatment outcome
- From:
Chinese Journal of Cardiology
2018;46(7):554-558
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the treatment results of cardiac rupture in patients with acute myocardial infarction (AMI) .
Method:Clinical data of 6 with cardiac rupture after AMI, who were hospitalized in our hospital from June 2015 to June 2017, were retrospectively analyzed,and the clinical manifestations, methods of treatment and outcomes were investigated.
Results:Cardiac function classification was Killip class Ⅱin all patients. There were 3 massive anterior wall myocardial infarction, 2 anterior wall myocardial infarction,and 1 inferior myocardial infarction. There were 4 patients with ventricular septal defect, 1 patient with rupture of papillary muscle,and 1 patient with left ventricular free wall rupture.All patients received continuous infusion of vasoactive medicines and treated with intra-aortic balloon pump(IABP), 2 patients (1 patient accepted operative treatment,and 1 patient received conservative treatment) were treated with extracorporeal membrane oxygenation (ECMO), mechanical ventilation,and continuous renal replacement therapy(CRRT).Three patients received surgical repair,1 case was supported by IABP, 1 case supported by ECMO,CRRT,and IABP,and 1 case did not use IABP or ECMO post operation. All 3 surgically treated patients recovered successfully and were discharged from hospital.Meanwhile, in the other 3 patients treated conservatively, 2 patients died in the hospital and 1 patient was discharged according to own will.
Conclusion:On the basis of vasoactive medicines and IABP, surgery repair is a feasible option for cardiac rupture patients secondary to AMI,and ECMO may improve the perioperative state in these patients.
