scholarly journals Post Infarction Ventricular Septal Rupture: Transcatheter intervention or Surgical repair?

2021 ◽  
Author(s):  
Fahad Alfares ◽  
Satinder Sandhu
Keyword(s):  
Mortality Rate ◽  
Acute Phase ◽  
Surgical Repair ◽  
Transcatheter Closure ◽  
Nyha Class ◽  
Defect Size ◽  
Ventricular Septal Rupture ◽  
Fatal Complication ◽  
Transcatheter Intervention ◽  
Risk Predictors

ABSTRACT Post infarction ventricular septal rupture (PIVSR) is an infrequent but potentially fatal complication of acute myocardial infarction. • The 30-day mortality rate with the transcatheter approach when performed in the acute phase (less than two weeks) was 25.3% compared to 50% when surgery is performed in the acute phase (within three weeks). • There is no correlation between defect size and mortality. • NYHA class IV and time to VSD closure are risk predictors for transcatheter closure for a 30-day mortality rate of 31.5%.

scholarly journals Pulmonary artery banding for initial treatment of ventricular septal rupture

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Yuta Koichi ◽  
Hiroto Kitahara ◽  
Naohiro Wakabayashi ◽  
Hayato Ise ◽  
Chiharu Tanaka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Pulmonary Artery ◽  
Surgical Repair ◽  
Pulmonary Artery Banding ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Transcatheter Intervention ◽  
Flow Through

Abstract Ventricular septal rupture (VSR) is a serious and fatal mechanical complication after acute myocardial infarction. Emergent or urgent, surgical/transcatheter intervention is necessary to treat VSR, though the outcome is not favorable. We performed temporary pulmonary artery banding (PAB) in an 85-year-old man who presented with chest pain to adjust the shunt flow through the VSR, which prevented further pulmonary edema and delayed the timing of surgical repair. There has been no report showing successful PAB performed for VSR after myocardial infarction.

scholarly journals Management and Outcome of Ventricular Septal Rupture Complicating Acute Myocardial Infarction: What Is New in the Era of Percutaneous Intervention?

Cardiology ◽  
2018 ◽  
Vol 141 (4) ◽  
pp. 226-232 ◽  
Author(s):  
Shi Tai ◽  
Jian-jun Tang ◽  
Liang Tang ◽  
Yu-qing Ni ◽  
Yanan Guo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mortality Rate ◽  
Acute Phase ◽  
Percutaneous Intervention ◽  
Percutaneous Closure ◽  
Ventricular Septal Rupture ◽  
Female Sex ◽  
Survivor Group

Background: Postinfarction ventricular septal rupture (PI-VSR) is a rare but devastating complication of acute myocardial infarction (AMI). Risk stratification in the acute phase is crucial for decision-making, and this study analyzed the risk factors for early mortality and the effects of various management options on the outcome of PI-VSR patients in the era of percutaneous intervention. Methods: A total of 96 patients with PI-VSR were identified and divided into an acute-phase survivor group (n = 46, survived ≥2 weeks after admission) and a nonsurvivor group (n = 50, died within 2 weeks after admission). Percutaneous closure was considered in acute-phase survivors. Patients were followed up for a mean 47 (quartiles 15–71) months by clinical visit or telephone interview. Results: The overall acute-phase (i.e., < 2 weeks after the diagnosis of PI-VSR) mortality rate was 52%. Female sex and Killip Class III–IV at admission were associated with an increased risk of acute-phase death. Of the 46 patients who survived ≥2 weeks, 20 underwent interventional occlusion and the procedure was successful in 19. Percutaneous closure in the acute-phase survivor group improved the immediate (21% in-hospital mortality rate) and long-term (53% mortality) outcomes. Conclusions: Patients with PI-VSR are at a high risk of acute-phase mortality. Female sex and severe cardiac dysfunction at admission are linked with a high rate of acute-phase deaths. Percutaneous closure in acute-phase survivors results in favorable short- and long-term benefits for PI-VSR patients.

VENTRICULAR SEPTAL RUPTURE: A RARE FATAL COMPLICATION OF CHRONIC STEROID USE

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 97A
Author(s):  
NAGA SAI SHRAVAN TURAGA ◽  
ERIC LEE ◽  
SHASHITHA GAVINI ◽  
KRISHNA NAGENDRAN
Keyword(s):  
Ventricular Septal Rupture ◽  
Fatal Complication ◽  
Steroid Use

scholarly journals Transcatheter closure of ventricular septal rupture with prolonged support of intra-aortic balloon pump after primary PCI: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chuan Yang ◽  
Yong Sun ◽  
Deling Zou ◽  
Zhaoqing Sun ◽  
Xinzhong Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Transcatheter Closure ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Drug Eluting Stent ◽  
Ventricular Septal Rupture ◽  
Total Occlusion ◽  
Ventricular Ejection Fraction ◽  
Intra Aortic Balloon Pump

Abstract Background Ventricular septal rupture (VSR) is a rare but severe complication of acute myocardial infarction (AMI). For such cases, surgical repair is recommended by major guidelines, but not always possible for such cases. Case presentation A 72-year-old man presented to the emergency room. ECG showed the ST-segment was elevated by 2–3 mm in lead II, III, and aVF, with Q-waves. Coronary angiography (CAG) showed multi-vessel disease with a total occlusion of the right coronary artery (RCA) and severe stenosis of the left anterior descending artery (LAD). A diagnosis of acute inferior myocardial infarction was made. VSR occurred immediately after percutaneous coronary intervention (a 2.5 × 20 mm drug-eluting stent implanted in RCA), and the patient developed cardiogenic shock. An intra-aortic balloon pump (IABP) was used to stabilize the hemodynamics. Transthoracic echocardiography (TTE) revealed an 11.4-mm left-to-right shunt in the interventricular septum. An attempt was made to reduce the IABP augmentation ratio for weaning on day 12 but failed. Transcatheter closure was conducted using a 24-mm double-umbrella occluder on day 28. The patient was weaned from IABP on day 31 and underwent secondary PCI for LAD lesions on day 35. The patient was discharged on day 41. Upon the last follow-up 6 years later, CAG and TTE revealed no in-stent restenosis, no left-to-right shunt, and 51% left ventricular ejection fraction. Conclusions Prolonged implementation of IABP can be a viable option to allow deferred closure of VSR in AMI patients, and transcatheter closure may be considered as a second choice for the selected senior and vulnerable patients, but the risk is still high.

scholarly journals Ventricular Septal Rupture Secondary to Myocardial Infarction Post Fibrinolytic Therapy: A Case Report

2019 ◽  
Author(s):  
Ankitha Peetha ◽  
Nahida Farheen Shaik ◽  
Spandana Ayela
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Mortality Rate ◽  
High Mortality ◽  
Anterior Wall ◽  
Fibrinolytic Therapy ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Surgical Emergency

Myocardial infarction can be complicated by Ventricular septal rupture which is a rare fatal grim mechanical complication of MI which is a surgical emergency due to its incredibly high mortality rate. We depict a case of Anterior wall MI which was complicated by Ventricular septal rupture post fibrinolytic therapy.

scholarly journals Surgical Repair of Post Infarction Ventricular Septal Rupture: An 18 Years’ Retrospective Multicenter Study

2021 ◽  
Author(s):  
Zohre Mohammadi ◽  
Masoud Majidi ◽  
Saman Rostambeigi ◽  
Parham Sadeghipour ◽  
Anahita Tatavoosi ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Surgical Repair ◽  
Pressure Overload ◽  
Coronary Bypass ◽  
Annual Number ◽  
Consecutive Series ◽  
Ventricular Septal Rupture ◽  
Low Cardiac Output ◽  
Hemodynamic Deterioration ◽  
Acute Mi

Background: Ventricular Septal Rupture (VSR) is a rare but challenging complication after myocardial infarction (MI). In the presence of acute MI, volume and pressure overload lead to acute heart decompensation. The present study was designed to evaluate the early surgical outcome of VSR for over 18 years. Method: This multicenter study was done during 2000-2018, in which 99 patients with post-MI VSR were included. Results: The patients (n=11) presenting hemodynamic deterioration at the time of hospital admission, died before any attempt for surgery. A consecutive series of 88 patients with surgical repair of VSR was evaluated. The mean interval from MI to VSR diagnosis was 7.5±7.2 days and from admission to the operation was 5±5 days. VSR location did not influence the outcome (p=0.1). The concomitant coronary bypass was done for all patients; two-vessel disease was more prevalent (39%). Only 25 patients survived and left the hospital (13 patients died in the operating room due to the failure of pump weaning and 50 patients in the ICU due to low cardiac output). Predictors of poor prognosis included low ejection fraction (p=0.01), prolonged pump time (p=0.01), and operation in the second half of this period (p=002). Conclusion: Despite the improvement in perioperative management and cardiac surgery techniques, the perioperative mortality rate of VSR has remained high where the assist device is not accessible. We suggest VSR repair limited to certain centers with adequate experiences because of the low average annual number.

Percutaneous closure of giant ascending aortic pseudoaneurysm: 22 years after modified BlalockTaussig shunt with a septal occluder device

2021 ◽  
pp. 1-4
Author(s):  
Ikram Massoud ◽  
Atef Yehia
Keyword(s):  
Standard Treatment ◽  
Surgical Repair ◽  
Ascending Aorta ◽  
Stent Grafts ◽  
Fatal Complication ◽  
Aortic Pseudoaneurysm ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
Aortopulmonary Fistula ◽  
Ascending Aortic Pseudoaneurysm

Abstract Pseudoaneurysm of the ascending aorta is rare (1–2%) and a potentially fatal complication following cardiac surgeries. Surgical repair is still the gold standard treatment of ascending aortic pseudoaneurysm. However, endovascular repair methods including stent grafts and Septal Occluder devices have been reported. We report a case of 38-year-old female patient who presented with giant ascending aortic pseudoaneurysm, and aortopulmonary fistula 22 years after modified BlalockTaussig shunt was managed by the transcatheter method. Septal Occluder device 20 mm diameter was delivered to seal the ostium.

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