Off pump repair of left ventricular rupture following mitral valve replacement: The crucial assistance of the IntraAortic Balloon Pump

AbstractINTRODUCTIONLeft ventricular (LV) rupture is a not as frequent, but potentially lethal complication of mitral valve replacement or repair.PRESENTATION OF CASEWe report a case of a 67-year-old man who underwent mitral valve replacement and Cox Maze IV procedure. A massive bleed from the LV rupture was noted postoperatively while the patient was extubated. The control of bleeding was impossible until an IntraAortic Balloon Pump (IABP) was inserted. A bovine pericardial patch was applied, overlapping an extensive epicardial area, perimetrically of the hematoma. Between the epicardium and the pericardial patch we applied an autologous fibrin sealant.DISCUSSIONThe off-pump technique used to repair the LV rupture after a MVR, is more feasible when the patient is supported by an IABP that subsequently decreases the tension of the myocardial suture site.CONCLUSIONThe IABP, is a necessary device, that decreases the tension along the suture site post a left ventricular rupture following a MVR