Successful sutureless repair of multiple left ventricular free wall ruptures due to Takotsubo cardiomyopathy: a case report
Abstract Background Takotsubo cardiomyopathy (TCM) is a temporary and reversible systolic abnormality of the left ventricular apical area resembling a myocardial infarction. Cardiac rupture due to TCM is a rare but fatal complication. Without cardiac surgery, 94% of patients with left ventricular fr...
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Japan Surgical Society
2024-02-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-024-01848-3 |
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| author | Hiroto Yasumura Koji Tao Ryo Imada Yushi Yamashita Naoki Tateishi Tamahiro Kinjo |
| author_facet | Hiroto Yasumura Koji Tao Ryo Imada Yushi Yamashita Naoki Tateishi Tamahiro Kinjo |
| author_sort | Hiroto Yasumura |
| collection | DOAJ |
| description | Abstract Background Takotsubo cardiomyopathy (TCM) is a temporary and reversible systolic abnormality of the left ventricular apical area resembling a myocardial infarction. Cardiac rupture due to TCM is a rare but fatal complication. Without cardiac surgery, 94% of patients with left ventricular free wall rupture (LVFWR) due to TCM die. Furthermore, successful surgical cases are rare. We report herein the successful treatment of multiple LVFWRs due to TCM using a sutureless repair. Case presentation An 80-year-old man quarreled with his daughter and had a sudden onset of chest pain. He was transferred to our hospital in shock. Electrocardiography showed ST elevation and contrast-enhanced computed tomography revealed a bloody pericardial effusion. Emergent coronary angiography showed no significant stenosis. Cardiac arrest ensued because of cardiac tamponade. Emergent surgery was undertaken and three oozing lacerations on the lateral and inferior walls were noted. A sutureless repair was performed using TachoSil® patches. We also applied Surgicel Nu-Knit® absorbable hemostat with Hydrofit® where TachoSil® failed to completely adhere because of hematoma formation and achieved complete hemostasis. We diagnosed the ruptures due to TCM according to the Mayo criteria. The patient was discharged on postoperative day 71. Conclusions A sutureless repair using TachoSil® patches and Surgicel® with Hydrofit® is a minimally invasive and effective method for the treatment of multiple LVFWRs due to TCM. |
| format | Article |
| id | doaj-art-d1bc3da5799e4571bdce0acab23d3cd5 |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-d1bc3da5799e4571bdce0acab23d3cd52025-08-20T03:58:50ZengJapan Surgical SocietySurgical Case Reports2198-77932024-02-011011510.1186/s40792-024-01848-3Successful sutureless repair of multiple left ventricular free wall ruptures due to Takotsubo cardiomyopathy: a case reportHiroto Yasumura0Koji Tao1Ryo Imada2Yushi Yamashita3Naoki Tateishi4Tamahiro Kinjo5Department of Cardiovascular Surgery, National Hospital Organization Kagoshima Medical CenterDepartment of Cardiovascular Surgery, National Hospital Organization Kagoshima Medical CenterDepartment of Cardiovascular Surgery, National Hospital Organization Kagoshima Medical CenterDepartment of Cardiovascular Surgery, National Hospital Organization Kagoshima Medical CenterDepartment of Cardiovascular Surgery, National Hospital Organization Kagoshima Medical CenterDepartment of Cardiovascular Surgery, National Hospital Organization Kagoshima Medical CenterAbstract Background Takotsubo cardiomyopathy (TCM) is a temporary and reversible systolic abnormality of the left ventricular apical area resembling a myocardial infarction. Cardiac rupture due to TCM is a rare but fatal complication. Without cardiac surgery, 94% of patients with left ventricular free wall rupture (LVFWR) due to TCM die. Furthermore, successful surgical cases are rare. We report herein the successful treatment of multiple LVFWRs due to TCM using a sutureless repair. Case presentation An 80-year-old man quarreled with his daughter and had a sudden onset of chest pain. He was transferred to our hospital in shock. Electrocardiography showed ST elevation and contrast-enhanced computed tomography revealed a bloody pericardial effusion. Emergent coronary angiography showed no significant stenosis. Cardiac arrest ensued because of cardiac tamponade. Emergent surgery was undertaken and three oozing lacerations on the lateral and inferior walls were noted. A sutureless repair was performed using TachoSil® patches. We also applied Surgicel Nu-Knit® absorbable hemostat with Hydrofit® where TachoSil® failed to completely adhere because of hematoma formation and achieved complete hemostasis. We diagnosed the ruptures due to TCM according to the Mayo criteria. The patient was discharged on postoperative day 71. Conclusions A sutureless repair using TachoSil® patches and Surgicel® with Hydrofit® is a minimally invasive and effective method for the treatment of multiple LVFWRs due to TCM.https://doi.org/10.1186/s40792-024-01848-3Takotsubo cardiomyopathyLeft ventricular ruptureSutureless repair |
| spellingShingle | Hiroto Yasumura Koji Tao Ryo Imada Yushi Yamashita Naoki Tateishi Tamahiro Kinjo Successful sutureless repair of multiple left ventricular free wall ruptures due to Takotsubo cardiomyopathy: a case report Surgical Case Reports Takotsubo cardiomyopathy Left ventricular rupture Sutureless repair |
| title | Successful sutureless repair of multiple left ventricular free wall ruptures due to Takotsubo cardiomyopathy: a case report |
| title_full | Successful sutureless repair of multiple left ventricular free wall ruptures due to Takotsubo cardiomyopathy: a case report |
| title_fullStr | Successful sutureless repair of multiple left ventricular free wall ruptures due to Takotsubo cardiomyopathy: a case report |
| title_full_unstemmed | Successful sutureless repair of multiple left ventricular free wall ruptures due to Takotsubo cardiomyopathy: a case report |
| title_short | Successful sutureless repair of multiple left ventricular free wall ruptures due to Takotsubo cardiomyopathy: a case report |
| title_sort | successful sutureless repair of multiple left ventricular free wall ruptures due to takotsubo cardiomyopathy a case report |
| topic | Takotsubo cardiomyopathy Left ventricular rupture Sutureless repair |
| url | https://doi.org/10.1186/s40792-024-01848-3 |
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