Right Ventricular Wall Dissection With Ventricular Septal Rupture Following Myocardial Infarction Visualized on 3-Dimensional Transthoracic Echocardiography

Hakuno, Daihiko; Isobe, Satoshi; Masaki, Nobuyuki; Adachi, Takeshi

doi:10.1253/circj.cj-14-1246

Cited by 6 publications

(9 citation statements)

References 9 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A total of 108 reports were identified, of which 22 full‐text articles with 36 cases met our inclusion criteria (including 15 case reports, 3 case series, 2 systematic reviews, one prospective study, and one letter) . The included studies are summarized in Table of the supplementary material.…”

Section: Resultsmentioning

confidence: 99%

Postinfarction intramyocardial dissection, an interesting case report and systematic review

et al. 2019

View full text Add to dashboard Cite

Intramyocardial dissection (IMD) with ventricular septal rupture (VSR) following myocardial infarction (MI) is a rare subacute form of cardiac rupture. The evidence available in this regard is scarce. We aimed to share our experience and conduct a systematic review of previous cases. We searched the literature and performed a systematic review of previous cases. A total of 37 cases of IMD with VSR were included (1 our original and 36 literature cases). Mean age was 68 ± 8 years and 20 (54.1%) patients were male. Anterior and inferior MI were observed in 14 (37.8%) and 23 (62.2%) cases, respectively. The dissected area was the septum, RV, both septum and RV, or LV apex in 21 (56.8%), 9 (24.3%), 5 (13.5%), and 2 (5.4%), respectively. Apicoseptal and inferoseptal VSR were observed in 15 (40.5%) and 22 (59.5%) cases, respectively. At least one occluded artery was observed in 29 (90.6%) of cases. Reperfusion therapy was done for 15 (40.5%) cases before the VSR occurred.Surgery, percutaneous, and medical therapy were done for 26 (70.3%), 3 (8.1%), and 7 (18.9%) cases, respectively. The mortality rate was significantly higher in the medical versus surgical-treated group (85.7% versus 42.3%, P = .027). There was a trend to higher mortality in the group with dissection of both septum and RV (P = .15). We concluded that echocardiography has a critical role in diagnosing this complication.Surgery is mandatory in IMD with VSR.

show abstract

Section: Resultsmentioning

confidence: 99%

Postinfarction intramyocardial dissection, an interesting case report and systematic review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The muscular architecture of cardiac ventricles can additionally account for the extension and formation of RV dissecting tract, since the texture of myocardial fibers at the base may be less dense than that at the apex. Myocardial ischemia, edema, and increased cavity pressure lead to the myocardial disruption and the entry of blood from infarcted LV inferior wall beyond the septum into RV myocardium to form a dissection tract with subsequent re‐entry into the lower pressure right ventricle at a separate point . However, this complicated situation owns a very high mortality rate.…”

Section: Discussionmentioning

confidence: 99%

“…Myocardial ischemia, edema, and increased cavity pressure lead to the myocardial disruption and the entry of blood from infarcted LV inferior wall beyond the septum into RV myocardium to form a dissection tract with subsequent re-entry into the lower pressure right ventricle at a separate point. 6,7 However, this complicated situation owns a very high mortality rate. Left-to-right shunting can result in volume overload of the left ventricle, while the RV pump fails to fill the left-sided chambers due to the presence of RV infarction and dissection, which exacerbates the low cardiac As a fast and preferred method, echocardiography can describe the pathological structure of the septum and RV wall, and threedimensional TTE may provide additional morphologic information.…”

Section: Discussionmentioning

confidence: 99%

Ventricular septal rupture with right ventricular wall dissection after inferior ventricular infarction: A case report and literature review

Kong

Wang

et al. 2019

J of Clinical Ultrasound

View full text Add to dashboard Cite

Right ventricular (RV) wall dissection following ventricular septal rupture related to inferior myocardial infarction (MI) is an extremely rare complication with a high mortality rate. We report the case of a 61‐year‐old man who was admitted to our hospital because of syncope and intermittent chest pain with a precordial murmur. Transthoracic echocardiography showed a rupture at the basal infero‐posterior septum and RV free‐wall dissection forming an echolucent cavity that extended beyond the septum and subsequently re‐entered into RV chamber. The patient's overall cardiac and renal functions deteriorated and he died 24 days after the diagnosis. We present a literature review of the published cases of complex dissecting tracts through the septum and RV wall in ischemic context.

show abstract

“…Two‐dimensional transthoracic echocardiography (2DTEE) has frequently been used in conjunction with 2DTTE, especially in patients with poor acoustic windows and also to guide its closure in both percutaneous and intraoperative settings . Recently, the use of 2D imaging has been supplemented by 3DTTE in a few case studies reported in the literature . The advent of 3DTEE began with the introduction of 3D reconstruction of 2DTEE images, and initially, this technique was used to comprehensively assess VSR .…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Recently, the use of 2D imaging has been supplemented by 3DTTE in a few case studies reported in the literature. [11][12][13][14] [17][18][19] In one case report, 19 capitalizes on the inherent deficiencies of 2D imaging. 2D imaging is only able to capture a thin slice of a given cardiac structure at any point in time.…”

Section: The Icc For Both Intra-and Inter-observer Variability For Almentioning

confidence: 99%

Incremental value of live/real time three‐dimensional transesophageal echocardiography in the assessment of ventricular septal rupture following acute myocardial infarction

et al. 2017

View full text Add to dashboard Cite

Ventricular septal rupture is a serious complication following acute myocardial infarctions and is associated with a significant mortality rate. Classically, two-dimensional transthoracic echocardiography has been used to diagnose this complication and visualize its location. Two-dimensional transesophageal echocardiography has supplemented the transthoracic approach by providing more accurate assessment of the defect size and in guiding closure both percutaneously and intraoperatively. This modality, however, is limited to two-dimensional views only, and a greater breadth of information is instead available through the use of three-dimensional transesophageal echocardiography. We present a series of 11 patients in which live/real time three-dimensional transesophageal echocardiography offered incremental benefits over two-dimensional imaging alone.

show abstract

Right Ventricular Wall Dissection With Ventricular Septal Rupture Following Myocardial Infarction Visualized on 3-Dimensional Transthoracic Echocardiography

Cited by 6 publications

References 9 publications

Postinfarction intramyocardial dissection, an interesting case report and systematic review

Postinfarction intramyocardial dissection, an interesting case report and systematic review

Ventricular septal rupture with right ventricular wall dissection after inferior ventricular infarction: A case report and literature review

Incremental value of live/real time three‐dimensional transesophageal echocardiography in the assessment of ventricular septal rupture following acute myocardial infarction

Contact Info

Product

Resources

About