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Post-infarct left ventricular free wall rupture and ventricular septal defect managed by pericardial aspiration during transport to referral hospital

^a Department of Cardiothoracic Surgery, Linköping Heart Center, University Hospital, SE-581 85 Linköping, Sweden
^b Department of Cardiothoracic Anesthesia, Linköping Heart Center, University Hospital, SE-581 85 Linköping, Sweden
^c Department of Internal Medicine, Ryhov Hospital, Jönköping, Sweden
^d Department of Radiology, Ryhov Hospital, Jönköping, Sweden

^* Corresponding author. Tel.: +46-13-222-000; fax: +46-13-100-246
rolf.svedjeholm{at}lio.se

Although left ventricular free wall rupture is a comparatively common cause of death in acute myocardial infarction survival is infrequently reported. However, even in cases where surgical expertise is not immediately available the condition can be temporarily controlled by judicious pericardial aspiration and blood transfusion until definitive repair can be undertaken. Here we report the successful management of a patient sustaining combined left ventricular free wall rupture and ventricular septal rupture in a community hospital 130 km from the referral center.

Key Words: Acute myocardial infarction; Complications; Left ventricular free wall rupture; Fibrinogen