MATERIAL AND METHODS: Between January 1983 and May 1999, 12.405 patients were treated by the surgical team of the Heart Institute (InCor) with the diagnosis of acute myocardial infarction (AMI). From these patients, 127 (1.02%) had left ventricular free wall rupture as an ischemic complication of the myocardial infarction. The cardiac rupture was acute in 98 patients (77.1%) and sub-acute in 29 (22.9%). RESULTS: Twenty-four patients were operated on, 5 on acute rupture with 80% of hospital mortality and 19 on sub-acute rupture with 15.8% of hospital mortality. The post-operative overall survival including both groups was 70.8%. CONCLUSION: The conclusion was drawn that left ventricular free wall rupture is a severe complication of acute myocardial infarction that needs an immediate action. In acute ruptures, most patients develop hemodynamic deterioration without enough time to try to proceed any surgical correction. The sub-acute cases can be detected and monitored through periodic ecocardiographic exams after the AMI. In these cases the early surgical intervention, many times without using extra-corporeal circulation, has been increasing the chances of survival of the majority of these patients.
Heart ventricle; Myocardial infarction; Heart rupture, post-infartion
