TY - JOUR
T1 - Sutured and sutureless repair of postinfarction left ventricular free-wall rupture
T2 - A systematic review
AU - Matteucci, Matteo
AU - Fina, Dario
AU - Jiritano, Federica
AU - Blankesteijn, W. Matthijs
AU - Raffa, Giuseppe Maria
AU - Kowalewski, Mariusz
AU - Beghi, Cesare
AU - Lorusso, Roberto
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Postinfarction left ventricular free-wall rupture is a potentially catastrophic event. Emergency surgical intervention is almost invariably required, but the most appropriate surgical procedure remains controversial. A systematic review, from 1993 onwards, of all available reports in the literature about patients undergoing sutured or sutureless repair of postinfarction left ventricular free-wall rupture was European Journal of Cardio-Thoracic Surgery 56 (2019) 840-848 REVIEW doi:10.1093/ejcts/ezz101 Advance Access publication 1 April 2019 performed. Twenty-five studies were selected, with a total of 209 patients analysed. Sutured repair was used in 55.5% of cases, and sutureless repair in the remaining cases. Postoperative in-hospital mortality was 13.8% in the sutured group, while it was 14% in the sutureless group. A trend towards a higher rate of in-hospital rerupture was observed in the sutureless technique. The most common cause of inhospital mortality (44%) was low cardiac output syndrome. In conclusion, sutured and sutureless repair for postinfarction left ventricular free-wall rupture showed comparable in-hospital mortality. However, because of the limited number of patients and the variability of surgical strategies in each reported series, further studies are required to provide more consistent data and lines of evidence.
AB - Postinfarction left ventricular free-wall rupture is a potentially catastrophic event. Emergency surgical intervention is almost invariably required, but the most appropriate surgical procedure remains controversial. A systematic review, from 1993 onwards, of all available reports in the literature about patients undergoing sutured or sutureless repair of postinfarction left ventricular free-wall rupture was European Journal of Cardio-Thoracic Surgery 56 (2019) 840-848 REVIEW doi:10.1093/ejcts/ezz101 Advance Access publication 1 April 2019 performed. Twenty-five studies were selected, with a total of 209 patients analysed. Sutured repair was used in 55.5% of cases, and sutureless repair in the remaining cases. Postoperative in-hospital mortality was 13.8% in the sutured group, while it was 14% in the sutureless group. A trend towards a higher rate of in-hospital rerupture was observed in the sutureless technique. The most common cause of inhospital mortality (44%) was low cardiac output syndrome. In conclusion, sutured and sutureless repair for postinfarction left ventricular free-wall rupture showed comparable in-hospital mortality. However, because of the limited number of patients and the variability of surgical strategies in each reported series, further studies are required to provide more consistent data and lines of evidence.
KW - Acute myocardial infarction
KW - Cardiac rupture
KW - Cardiac surgery
KW - Mechanical complication
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U2 - 10.1093/ejcts/ezz101
DO - 10.1093/ejcts/ezz101
M3 - Review article
C2 - 30938415
AN - SCOPUS:85070609227
VL - 56
SP - 840
EP - 848
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 5
ER -