scholarly journals Urgent hybrid approach in treatment of the acute myocardial infarction complicated by the ventricular septal rupture

2014 ◽  
Vol 142 (3-4) ◽  
pp. 226-228
Author(s):  
Mina Radosavljevic-Radovanovic ◽  
Nebojsa Radovanovic ◽  
Aleksandra Arandjelovic ◽  
Predrag Mitrovic ◽  
Ana Uscumlic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hybrid Approach ◽  
Stable Condition ◽  
Coronary Intervention ◽  
Operative Risk ◽  
Ventricular Septal Rupture ◽  
Surgical Closure ◽  
Hybrid Approaches ◽  
Hemodynamic State

Introduction. Ventricular septal rupture (VSR) in the acute myocardial infarction (AMI) is a rare but very serious complication, still associated with high mortality, despite significant improvements in pharmacological and surgical treatment. Therefore, hybrid approaches are introduced as new therapeutical options. Case Outline. We present an urgent hybrid approach, consisting of the initial percutaneous coronary intervention (PCI) of the infarct-related artery, followed by immediate surgical closure of the ventricular septal rupture, for treatment of high risk, hemodynamically unstable female patient with AMI caused by one-vessel disease and complicated by VSR and cardiogenic shock. Since the operative risk was also very high (EUROSCORE II 37%), this therapeutic decision was based on the assumption that preoperative PCI could promptly establish blood flow and thereby lessen the risks, duration and complexity of urgent cardiosurgical intervention, performed on the same day. This approach proved to be successful and the patient was discharged from the hospital on the fifteenth postoperative day in stable condition. Conclusion. In selected cases, with high operative risk and unstable hemodynamic state due to AMI complicated by VSR, urgent hybrid approach consisting of the initial PCI followed by surgical closure of VSR may represent an acceptable treatment option and contribute to the treatment of this complex group of patients.

scholarly journals Ventricular Septal Rupture – A Critical Condition as a Complication of Acute Myocardial Infarction

2015 ◽  
Vol 1 (4) ◽  
pp. 162-166 ◽  
Author(s):  
Martin Novak ◽  
Ota Hlinomaz ◽  
Ladislav Groch ◽  
Michal Rezek ◽  
Jiri Semenka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Critical Condition ◽  
Stable Condition ◽  
Ventricular Septal Rupture ◽  
Fatal Complication ◽  
Aggressive Approach ◽  
Surgical Closure ◽  
Catheter Closure ◽  
Immediate Surgery

Abstract Ventricular septal rupture is a potentially fatal complication of acute myocardial infarction. The key to management of this critical condition is an aggressive approach to haemodynamic stabilization and surgical closure of the rupture. Where there is a small rupture and the patient is in a haemodynamically stable condition, surgery can be delayed with the prospect of achieving better perioperative results. However, in unstable critically ill patients either immediate surgery or extracorporeal membranous oxygenation support and delayed surgery is indicated. In some patients, trans-catheter closure may be considered as an alternative to surgery.

scholarly journals Percutaneous Closure of Post Myocardial Infarction Ventricular Septal Rupture in an Unstable Hemodynamic State, Using an Unconventional Internal Jugular venous access;

2021 ◽  
Author(s):  
behzad alizadeh ◽  
javad ramezani ◽  
bita zargaran
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Venous Access ◽  
Ventricular Septal Rupture ◽  
Chest Discomfort ◽  
Percutaneous Coronary ◽  
Hemodynamic Deterioration ◽  
Hemodynamic State

We report a 56-year-old woman with multiple cardiovascular risk factors who initially present with chest discomfort. She underwent successful primary percutaneous coronary intervention (PCI) on left anterior descending and right coronary artery . Few hours later and after the hemodynamic deterioration of patient,

scholarly journals Transcatheter closure of post myocardial Infarction ventricular septal rupture with the Amplatzer Septal occluder

2021 ◽  
Vol 18 (2) ◽  
pp. 65-68
Author(s):  
Chandra Mani Adhikari ◽  
Manish Shrestha ◽  
Birat Timalsina ◽  
Amrit Bogati ◽  
Madhu Rokka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Surgical Intervention ◽  
Transcatheter Closure ◽  
Amplatzer Septal Occluder ◽  
Ventricular Septal Rupture ◽  
Surgical Closure ◽  
Amplatzer Device ◽  
Life Threatening ◽  
Life Threatening Complication

Ventricular septal rupture is a rare yet life threatening complication of acute myocardial infarction. Surgical closure is the treatment of choice however despite surgical intervention mortality remains high.  Transcatheter closure of ventricular septal rupture has emerged as a new alternative strategy which is less invasive potentially allowing early hemodynamic stabilization. We report a case of a 60-year-old male with post infarction ventricular septal rupture who was treated with percutaneous closure using an Amplatzer device at Shahid Gangalal National Heart Centre, Nepal. 

scholarly journals Percutaneous Coronary Intervention in Post-Infarction Ventricular Septal Rupture

2021 ◽  
Vol 5 (4) ◽  
pp. 146-150
Author(s):  
Suryono Suryono ◽  
Naesilla Naesilla ◽  
Ika Aulia Kurniasari ◽  
Toyibatul Hidayati ◽  
Madha Qoyyulledy Tursina ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Definitive Treatment ◽  
Drug Eluting Stent ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Percutaneous Coronary

Background: Ventricular septal rupture (VSR) is a fatal mechanical complication following acute myocardial infarction (AMI). The definitive treatment remains surgical repair, however several aspects are still debatable, including the timing of surgery. Patient’s refusal of treatment and lack of medical facilities put other challenges in management of VSR. Case presentation: A-48-year-old male with a history of diabetes mellitus and hypertension came with a late-presentation anterior AMI, and refused the reperfusion therapy. By the third day, he developed VSR and cardiogenic shock. The patient was also against any referral plan for further therapy. Hemodynamic status was optimally controlled with vasopressor and inotropic agents. The patient was discharged with a grade II-III New York Heart Association (NYHA) on the tenth day. In follow up evaluation a week later, the patient presented limb swelling and functional NYHA class III-IV. The patient agreed to received percutaneous coronary intervention (PCI). Drug eluting stent (DES) in left anterior descending (LAD) coronary artery was implanted successfully without defect closure. Follow-up after 12-months revealed no signs or symptoms of decompensated heart failure. Keywords: ventricular septal rupture; percutaneous coronary intervention; acute myocardial infarction

Increasing the Penetration of Primary Angioplasty in Europe

2012 ◽  
Vol 8 (1) ◽  
pp. 60 ◽  
Author(s):  
Zuzana Kaifoszova ◽  
Petr Widimsky ◽  
◽  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Treatment Guidelines ◽  
Coronary Intervention ◽  
Reperfusion Therapy ◽  
Success Factor ◽  
The Balkans ◽  
Life Saving ◽  
Percutaneous Coronary

Primary percutaneous coronary intervention (PPCI) is recommended by the European Society of Cardiology (ESC) treatment guidelines as the preferred treatment for ST-elevation acute myocardial infarction (STEMI) whenever it is available within 90–120 minutes of the first medical contact. A survey conducted in 2008 in 51 ESC countries found that the annual incidence of hospital admissions for acute myocardial infarction is around 1,900 patients per million population, with an incidence of STEMI of about 800 per million. It showed that STEMI patients’ access to reperfusion therapy and the use of PPCI or thrombolysis (TL) vary considerably between countries. Northern, western and central Europe already have well-developed PPCI services, offering PPCI to 60–90 % of all STEMI patients. Southern Europe and the Balkans are still predominantly using TL. Where this is the case, a higher proportion of patients are left without any reperfusion treatment. The survey concluded that a nationwide PPCI strategy results in more patients being offered reperfusion therapy. To address the inequalities in STEMI patients’ access to life-saving PPCI, and to support the implementation of the ESC STEMI treatment guidelines in Europe, the Stent for Life (SFL) Initiative was launched jointly by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and EuroPCR in 2008. National cardiac societies from Bulgaria, France, Greece, Serbia, Spain and Turkey signed the SFL Declaration at the ESC Congress in Barcelona in 2009. The aim of the SFL Initiative is to improve the delivery of, and STEMI patients’ access to, life-saving PPCI and thereby reduce mortality and morbidity. Currently, 10 national cardiac societies support the SFL Initiative in their respective countries. SFL national action programmes have been developed and are being implemented in several countries. The formation of regional PPCI networks involving emergency medical services, non-percutaneous coronary intervention hospitals and PPCI centres is considered to be a critical success factor in implementing PPCI services effectively. This article describes examples of how SFL countries are progressing in implementing their national programmes, thus increasing PPCI penetration in Europe.

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