Left ventricular free wall rupture in an elderly patient; report of a case

We successfully repaired left ventricular free wall rupture in a 91-year-old woman. She was admitted to our hospital because of consciousness loss. Blood pressure was only 60 mmHg on arrival. Contrast-enhanced computed tomography (CT) demonstrated massive pericardial effusion and transmural contrast defect of the left ventricular lateral wall in the delayed phase. Upon surgery there was massive clot around the heart. A localized infracted area on the left ventricular lateral wall was exposed using off-pump coronary artery bypass (OPCAB) technique. There was mild bleeding only during diastolic phase. Three mattress sutures of 3-0 prolene with Teflon felt strips were placed to control the bleeding under beating heart. A sheet of collagen and fibrin glue was also applied. Postoperative course was uneventful. This type of left ventricular rupture could be less invasively repaired by off-pump technique. As far as we investigated, this is the oldest patient of ventricular free wall rupture successfully repaired.