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  • Title: [A successful repair of concomitant rupture of the interventricular septum and left ventricular free wall after acute myocardial infarction].
    Author: Fukumoto H, Nishimoto T, Hashimoto T, Morita H.
    Journal: Nihon Kyobu Geka Gakkai Zasshi; 1992 Jul; 40(7):1105-9. PubMed ID: 1506704.
    Abstract:
    A 74-year-old woman had acute anteroseptal myocardial infarction. Tissue plasminogen activator (t-PA) was infused intravenously about five hours later from the onset of myocardial infarction. Six hours after the infusion of t-PA her blood pressure fell suddenly with the appearance of a grade 3/6 holosystolic murmur. There was a prominent step up of oxygen saturation in the right ventricle which indicated the presence of a left-to-right shunt. Intraaortic balloon pumping for the support of cardiac function was ineffective. At the emergent operation concomitant rupture of the left ventricular free wall and interventricular septum was seen and successfully repaired. She could be weaned from cardiopulmonary bypass easily with the aid of the intraaortic balloon pumping. Her postoperative course was uneventful. The postoperative angiography showed good left ventricular wall motion without any residual shunt.
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