Sutureless repair and deep sedation for a blow-out type post-infarction left ventricular free wall rupture

Abstract

A 71-year-old woman who was resuscitated from cardiac arrest after pericardial drainage, was admitted to our hospital. Enhanced computed tomography demonstrated pericardial effusion due to rupture of posterior ventricular myocardium. She underwent emergent surgical repair. A 20-mm tear in the extensively necrotic left ventricular posterior wall and active hemorrhage were identified. Sutureless repair using three sheets of TachoSil (CSL Behring, Tokyo, Japan) and fibrin glue was performed. To reduce ventricular pressure to avoid re-rupture and formation of ventricular aneurysm, deep sedation was followed in the intensive care unit for 2 weeks. The patient returned to her normal daily life and is progressing well for more than 5 months after the surgery.