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 Transcatheter Closure of Ventricular Septal Rupture First in Bangladesh - A Case Report

2015 ◽  
Vol 7 (2) ◽  
pp. 150-152
Author(s):  
NAM Momenuzzaman ◽  
Solaiman Hossain ◽  
Fatema Begum ◽  
Kaisar Nasrullah Khan ◽  
AM Shafique ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Surgical Intervention ◽  
Transcatheter Closure ◽  
Rare Complication ◽  
Rapid Diagnosis ◽  
Ventricular Septal Rupture ◽  
Short Term ◽  
Amplatzer Device ◽  
Short Term Mortality

Ventricular septal rupture is a rare complication of acute myocardial infarction with important hemodynamic consequences. Without a rapid diagnosis and correction by surgical intervention, the short-term mortality of these patients is higher than 90%. Early diagnosis is based on clinical examination and transthoracic echocardiography. Transcatheter closure of ventricular septal rupture in selected patients may save lives. We report a patient with ventricular septal rupture in acute myocardial infarction that was closed by an Amplatzer device. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22264 Cardiovasc. j. 2015; 7(2): 150-152

Postinfarction ventricular septal rupture closure without ventriculotomy

2016 ◽  
Vol 26 (8) ◽  
pp. 628-631 ◽  
Author(s):  
Dai Kawashima ◽  
Satoru Maeba ◽  
Masahiro Saito ◽  
Minoru Ono
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Tricuspid Valve ◽  
Ventricular Septal Rupture ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Postinfarction Ventricular Septal Rupture

Postinfarction ventricular septal rupture is a life-threatening complication of acute myocardial infarction. Although some novel techniques of ventricular septal rupture closure have been introduced, they involve ventriculotomy, a procedure that can cause a degree of impairment of the incised ventricle. We describe a case in which we closed a ventricular septal rupture through the tricuspid valve, without ventriculotomy.

scholarly journals The Role of Echocardiography in the Assessment of Ventricular Septal Rupture Postmyocardial Infarction

2017 ◽  
Vol 33 (4) ◽  
pp. 291-294 ◽  
Author(s):  
Michael Rampoldi ◽  
Eric Kallstrom
Keyword(s):  
Myocardial Infarction ◽  
Surgical Intervention ◽  
Rapid Assessment ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Anterior Myocardial Infarction ◽  
Postmyocardial Infarction ◽  
Life Threatening

Ventricular septal rupture (VSR) is a rare life-threatening mechanical complication secondary to acute myocardial infarction that usually occurs 2 to 8 days after infarction and frequently precipitates cardiogenic shock. The mortality rate for VSR has been reported to be between 41% and 80%; therefore, immediate surgical intervention should be considered. Furthermore, VSR is a complication of 0.17% to 0.31% of patients who present with an anterior myocardial infarction. Because of the rarity of this pathology, the role of transthoracic echocardiographic investigation will help to improve what is already considered a poor prognosis for these types of patients. This case study illustrates how transthoracic echocardiography plays an essential role in the rapid assessment and diagnosis of VSR in clinical practice.

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 TIMING OF SURGICAL INTERVENTION AFTER VENTRICULAR SEPTAL RUPTURE

2019 ◽  
Vol 48 (05) ◽  
pp. 17-21
Author(s):  
Guliko Kiliptari
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Haemodynamic Instability ◽  
Ventricular Septal Rupture ◽  
Middle Segment ◽  
Adequate Treatment ◽  
St Segment ◽  
Heart Rupture

Ventricular septal rupture (VSR) is a rare but lethal complication of acute myocardial infarction (AMI). patients presenting with ST-elevation MI (STEMI) were evaluated for heart rupture (VSR ) based on reperfusion strategy. , After undergoing a primary percutaneous coronary intervention (PCI), VSR was reported to occur in 0.23-0.71% of patients. Post-infarction VSR carries significant mortality (36.%) despite aggressive surgical management. Rupture develops after full-thickness (transmural) infarction of the ventricular septum and can occur at any anatomic location. Ventricular septal rupture is likely to be associated with total occlusion of the infarct-related artery. the newly formed communication results in left to right shunting of oxygenated blood from the high-pressure left ventricle to the lower-pressure right ventricle. .Mortality was highest in patients who underwent operation in the first 24 h, consistent with other investigators. The case reflects the important problem after myocardial infarction , ventricular septal rupture and challenges the timing of intervention Patient 70 year old,male,caucasion was admitted in our hospital with encephalopathy and hypotension.ECG revealed ST segment elevation in II,III,AVF,V4-V6 lead,ST segment depression in AVL,V1-V3 lead. Koronarography detected left main artery without important stenosis, 95 % stenosis of middle segment and 75% stenosis of distal part of left anterior descending artery.40% stenosis of middle segment of right coronary artery, occlusion of posterior descending artery.After recanalization and balloon predilatation of posterior descending artery, was parformed drug eluted stant implantation. transthoracic echocardiography (TTE) detected of postinfarction VSR (pict 3). The Colour Doppler was demonstrated of flow across the septum and left to rigt shunt. Conclusion: Ventricular septal rupture (VSR) is a rare but lethal complication of acute myocardial infarction (AMI). Mortality of patients is significantly depending o n timing of surgery. Operative management of patients can be complex, and having a systematic approach is helpful. The cornerstone of medical management of VSR is afterload reduction, and may be considered routine care.. According our case , surgical intervention was delayed and dispite adequate treatment patient was died . There is no clear evidence to guide the surgical management of patients who are in shock, as all approaches have shown extremely high mortality. Possible strategies include emergent surgery on individuals with marked haemodynamic instability and circulatory compromise.

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 Epidemiology of Post-Infarction Ventricular Septal Rupture in Patients Undergoing Surgical Repair at Different Times from the Development of Acute Myocardial Infarction

2021 ◽  
pp. 18-25
Author(s):  
Ramil A. Aliyev ◽  
Yelizaveta O. Lebedieva ◽  
Mykhailo M. Grusha ◽  
Kamran K. Musayev
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Surgical Intervention ◽  
Rapid Development ◽  
Myocardial Reperfusion ◽  
Time Interval ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Leading Role ◽  
Artery Disease

Introduction. The article is dedicated to the epidemiological aspects of the mechanical complication of acute myocardial infarction (AMI), particularly post-infarction ventricular septal rupture (VSR), problematic issues of its etiology and localization. Mortality of such patients is determined by rapid development of hemodynamic disorders and their severity, unpredictable clinical course, and the difficulty of early diagnosis. In addition, the high mortality rate of patients, especially when correcting the ventricular septal defect at the early stages after AMI, leaves open the question of the tactics of surgical treatment. The influence of certain risk factors of ischemic heart disease (IHD) on the development of post-infarction VSR is also considered. The aim. To study the epidemic features of post-infarction VSR in patients with different terms of surgical intervention after the development of AMI. Materials and methods. This study presents a retrospective analysis of 90 patients with coronary artery disease complicated by post-infarction VSR, who underwent surgical intervention for the period 2002-2019. The ages of hospitalized patients with post-infarction VSR ranged from 29 to 81 years. All the patients were divided into 3 groups depending on the time interval from AMI to surgical intervention. Results and discussion. It was found that post-infarction VSR is more common in men in the age range of 45-74 years after the manifestation of the first transmural AMI. More than a half of post-infarction VSR cases (56.7%) are associated with anterior localization of the ruptures in consequence of anterior AMI. Since the leading role in the treatment of AMI belongs to percutaneous coronary interventions (PCI), we analyzed the use of various reperfusion techniques to restore coronary blood flow in patients with post-infarction VSR. The analysis suggests that there are no statistically significant differences between the studied groups of patients with post-infarction VSR who underwent myocardial reperfusion (p = 0.103). Conclusions. The presence of chronic renal failure (CRF) in patients in the early post-infarction period can complicate the course of post-infarction VSR and affect perihospital mortality. The absence or untimeliness of myocardial reperfusion increases the risk of developing this complication of AMI. The ambiguous prognosis of treatment of post-infarction VSR makes a serious problem for clinicians.

scholarly journals An unusual presentation of acute myocardial infarction in physiotherapy direct access: findings from a case report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lorenzo Storari ◽  
Valerio Barbari ◽  
Fabrizio Brindisino ◽  
Marco Testa ◽  
Maselli Filippo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Visceral Pain ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Outpatient Setting ◽  
Direct Access ◽  
Life Threatening ◽  
Medical Referral

Abstract Background Shoulder pain (SP) may originate from both musculoskeletal and visceral conditions. Physiotherapists (PT) may encounter patients with life-threatening pathologies that mimic musculoskeletal pain such as Acute Myocardial Infarction (AMI). A trained PT should be able to distinguish between signs and symptoms of musculoskeletal or visceral origin aimed at performing proper medical referral. Case presentation A 46-y-old male with acute SP lasting from a week was diagnosed with right painful musculoskeletal shoulder syndrome, in two successive examinations by the emergency department physicians. However, after having experienced a shift of the pain on the left side, the patient presented to a PT. The PT recognized the signs and symptoms of visceral pain and referred him to the general practitioner, which identified a cardiac disease. The final diagnosis was acute myocardial infarction. Conclusion This case report highlights the importance of a thorough patient screening examination, especially for patients treated in an outpatient setting, which allow distinguishing between signs and symptoms of musculoskeletal from visceral diseases.

scholarly journals Appropriate timing of surgical intervention after transmural acute myocardial infarction

2003 ◽  
Vol 125 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Daniel C. Lee ◽  
Mehmet C. Oz ◽  
Alan D. Weinberg ◽  
Windsor Ting
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Surgical Intervention
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