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The goal of multiple organ procurement is to retrieve intact organs fully. This goal can only be reached if the organ dissection and preservation are optimal. [Copyright &y& Elsevier]

Two cases of right ventricular free wall rupture secondary to mediastinitis after cardiac surgery are reported. This complication is unusual and characterized by the singular mechanism of rupture (traction involving right ventricular free wall and chest adhesion) which occurs during episodes of coughing. Treatment by omentoplasty en sureda favorable outcome in both cases.

From 1978 to 1992, 121 cases of postinfarction left ventricular aneurysm (99 males, 22 females, mean age 60 years) were operated on. The authors insist on a high rate of clinical arhythmogenicity (31.4%) and associated mechanical complications (21%). 76% of patients were in functional NYHA class III or IV. Resection was performed in 90% of patients, plication in 10%. 58% underwent coronary artery bypass grafting (1.7 graft/patient), 16% encircling ventriculotomy, 8% mitral valve replacement and 13% closure of ventricular septal defect. Operative mortality was 14.9% (10% when other mechanical complications where excluded). 5-year survival is 67.9%. Late cardiac deaths are as follow: left ventricular failure (1.8% A/P), Sudden death (1.4% A/P), Myocardial infarction (0.6% A/P). 82% of survivals are in functional NYHA class I or II. Only functional class NYHA III or IV is predictive of late death. We conclude that postinfarction left ventricular aneurysm remains a high risk complication especially when associated with other mechanical complications. When arhythmogenicity is present we suggest rhythmologic surgery and in all cases, complete revascularization.