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Surgical treatment of ventricular septal rupture following myocardial infarction in an aged patient with bronchial asthma Tsuyoshi Shimizu 1 , Naoki Konagai 1 , Hiroshi Hino 1 , Takehiko Kudo 1 , Takashi Sakai 2 , Toshihiko Ishii 2 , Kenichi Muto 2 , Kinichi Furukawa 3 1The Department of Cardiovascular Surgery, Hachioji Medical Center, Tokyo Medical College 2The Department of Cardiology, Hachioji Medical Center, Tokyo Medical College 3The Department of Surgery, Tokyo Medical College pp.1127-1131
Published Date 1989/10/15
DOI https://doi.org/10.11477/mf.1404205566
  • Abstract
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Urgent surgery for ventricular septal rupture fol-lowing myocardial infarction in a 75-year-old female with bronchial asthma was successfully perfor-med. On Feb 28, 1988, she had chest pain, and was admitted 5 days later because of the appearan-ce of heart murmur. Pansytolic murmur (Levine 4/VI) on 3 LSB and piping sound on both lung fields was heard, ECG showed acute anteroseptal infarction. Right heart Swan-Ganz catheterization revealed left to right shunt, and the diagnosis was ventricular septal rupture following acute antero-septal infarction with bronchial asthma. The initial hemodynamic condition was not serious, but soon after the diagnosis was confirmed, IABP was in-serted and operation was indicated because of the advanced age, high shunt ratio (70%) and compli-cation of bronchial asthma. The operation was per-formed a day after septal rupture. The perforationin the ventricular septum of the apex was sutured with a xenopericardium patch by mattres sutures through a left ventricle approach, and the ventri-cular wall was closed with this patch together. Thepostoperative course was uneventful, and the patient was discharged on the 43rd day after the opera-tion.


Copyright © 1989, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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