Intraprocedural left ventricular free wall rupture diagnosed by left ventriculogram in a patient with infero-posterior myocardial infarction and severe aortic stenosis

Konishi, Takao; Funayama, Naohiro; Yamamoto, Tadashi; Nishihara, Hiroshi; Hotta, Daisuke; Kikuchi, Kenjiro; Yokoyama, Hideo; Ohori, Katsumi

Intraprocedural left ventricular free wall rupture diagnosed by left ventriculogram in a patient with infero-posterior myocardial infarction and severe aortic stenosis

Konishi, Takao; Funayama, Naohiro; Yamamoto, Tadashi et al.

BMC cardiovascular disorders, 2016, 16, 126

Permalink : https://hdl.handle.net/2115/62614

このアイテムのアクセス数:1,351件（2026-08-15 19:53 集計）

閲覧可能ファイル

ファイル	フォーマット	サイズ	閲覧回数	説明
art_10.1186_s12872-016-0302-7	pdf	2.57 MB	683
(2015.12.14)Movie1R3	mpg	2.97 MB	102	Additional file: left ventriculography
(2015.12.14)Movie2R3	mpg	6.01 MB	102	Additional file: left ventriculography

論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/62614
タイトル	Intraprocedural left ventricular free wall rupture diagnosed by left ventriculogram in a patient with infero-posterior myocardial infarction and severe aortic stenosis
著者	Konishi, Takao ; Funayama, Naohiro ; Yamamoto, Tadashi ; Nishihara, Hiroshi ; Hotta, Daisuke ; Kikuchi, Kenjiro ; Yokoyama, Hideo ; Ohori, Katsumi
著者名 Konishi, Takao
著者名 Funayama, Naohiro
著者名 Yamamoto, Tadashi
e-Rad_Researcher 50322805 著者名 Nishihara, Hiroshi
著者名 Hotta, Daisuke
著者名 Kikuchi, Kenjiro
著者名 Yokoyama, Hideo
著者名 Ohori, Katsumi
言語	英語
キーワード	Left ventricular wall rupture
	Acute myocardial infarction
	Aortic stenosis
	Angioplasty
	Intra-aortic balloon pump
	Catecholamine
発行日	2016-06-06
出版者	BioMed Central
収録物名	BMC cardiovascular disorders
巻(号)	16
ページ	126
抄録	Background: Left ventricular wall rupture remains a major lethal complication of acute myocardial infarction and hypertension is a well-known predisposing factor of cardiac rupture after myocardial infarction. Case presentation: An 87-year-old man was admitted to our hospital, diagnosed as acute myocardial infarction (AMI). The echocardiogram showed 0.67-cm2 aortic valve, consistent with severe aortic stenosis (AS). A coronary angiography showed a chronic occlusion of the proximal left circumflex artery and a 99 % stenosis and thrombus in the mid right coronary artery. During percutaneous angioplasty of the latter, transient hypotension and bradycardia developed at the time of balloon inflation, and low doses of noradrenaline and etilefrine were intravenously administered as needed. The patient suddenly lost consciousness and developed electro-mechanical dissociation. Cardio-pulmonary resuscitation followed by insertion of an intra-aortic balloon pump (IABP) and percutaneous cardiopulmonary support were initiated. The echocardiogram revealed moderate pericardial effusion, though the site of free wall rupture was not distinctly visible. A left ventriculogram clearly showed an infero-posterior apical wall rupture. Surgical treatment was withheld because of the interim development of brain death. Conclusions: In this patient, who presented with severe AS, the administration of catecholamine to stabilize the blood pressure probably increased the intraventricular pressures considerably despite apparently normal measurements of the central aortic pressure. IABP, temporary pacemaker, or both are recommended instead of intravenous catecholamines for patients with AMI complicated with significant AS to stabilize hemodynamic function during angioplasty.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution 4.0 International
PISSN	1471-2261
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1186/s12872-016-0302-7