Off pump repair of left ventricular rupture following mitral valve replacement: The crucial assistance of the IntraAortic Balloon Pump

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• 作者：Mihalis Argiriou ; ^{mihalisargiriou@ath.forthnet.gr} ; Vasilis Patris ; Niki Lama ; Orestis Argiriou ; Christos Charitos
• 关键词：LV ; left ventricle ; MVR ; mitral valve replacement ; MVA ; mitral valve area ; CPB ; cardio pulmonary bypass ; COPD ; chronic obstructive pulmonary disease ; IABP ; IntraAortic Balloon Pump ; IAB ; IntraAortic Balloon
• 刊名：International Journal of Surgery Case Reports
• 出版年：2013
• 出版时间：2013
• 年：2013
• 卷：4
• 期：1
• 页码：5-6
• 全文大小：226 K

文摘

INTRODUCTION

Left ventricular (LV) rupture is a not as frequent, but potentially lethal complication of mitral valve replacement or repair.

PRESENTATION OF CASE

We report a case of a 67-year-old man who underwent mitral valve replacement and Cox Maze IV procedure. A massive bleed from the LV rupture was noted postoperatively while the patient was extubated. The control of bleeding was impossible until an IntraAortic Balloon Pump (IABP) was inserted. A bovine pericardial patch was applied, overlapping an extensive epicardial area, perimetrically of the hematoma. Between the epicardium and the pericardial patch we applied an autologous fibrin sealant.

DISCUSSION

The off-pump technique used to repair the LV rupture after a MVR, is more feasible when the patient is supported by an IABP that subsequently decreases the tension of the myocardial suture site.

CONCLUSION

The IABP, is a necessary device, that decreases the tension along the suture site post a left ventricular rupture following a MVR.