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ABSTRACT: In rare cases of posterior myocardial infarction, septal rupture is the consequence of a dissecting interventricular hematoma that evolves as a fibrotic septal chamber with two separate communications, towards left and right ventricle. This unusual anatomical pattern is generally unsuspected and described as a normal interventricular defect associated with a basal left ventricular aneurysm or pseudoaneurysm. We present a case where echocardiography and ventricular angiography did not detect this situation. As surgical implications are important, this peculiar anatomical pattern should be suspected especially in patients with asymptomatic postinfarction posterior septal rupture or in those with minimal clinical impairment.
Journal of Cardiovascular Medicine 09/2009; 11(8):622-4. · 1.51 Impact Factor
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ABSTRACT: Repair of posterior left ventricular ischemic aneurysms implies an extracardiac approach to reshape the ventricular geometry frequently associated with mitral surgery. A transatrial technique was described for lesions following mitral surgery or for subvalvular idiopathic cases. A transmitral approach was used for ischemic or traumatic pseudoaneurysm. We describe a case of postinfarction posterior true aneurysm with associated mitral incompetence. Both lesions were treated through an intracardiac approach. The posterior mitral leaflet was detached posteriorly to close the aneurysm with a patch, and the valve replaced sparing all subvalvular apparatus. This technique seems to be safe and allows to treat both lesions avoiding ventriculotomy.
Journal of Cardiac Surgery 07/2009; 25(1):23-5. · 0.87 Impact Factor
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Journal of Cardiovascular Medicine 01/2009; 9(12):1287-9. · 1.51 Impact Factor
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ABSTRACT: Extracorporeal membrane oxygenation (ECMO) is becoming a gold standard in acute heart failure, not responsive to inotrops and intra-aortic balloon contrapulsation. This diffusion is due to the possibility to implant it through peripheral cannulation and to perform long-time assistance. Nevertheless, this technique implies some problems concerning inferior limb perfusion. It is widely accepted that arterial distal cannulation and perfusion of the limb is mandatory, especially for long periods of assistance; but the necessity to implant a distal venous drainage is still discussed. We would like to present our experience on peripheral ECMO where we could avoid venous distal drainage uneventfully.
ASAIO journal (American Society for Artificial Internal Organs: 1992) 56(1):35-6. · 1.39 Impact Factor
