The Potential Impact of Primary Percutaneous Coronary Intervention on Ventricular Septal Rupture Complicating Acute Myocardial Infarction

Yip, Hon‐Kan; Fang, Chih-Yuan; Tsai, Kuei-Ton; Chang, Hsueh‐Wen; Yeh, Kuo-Ho; Fu, Morgan; Wu, Chiung‐Jen

doi:10.1378/chest.125.5.1622

Cited by 79 publications

(56 citation statements)

References 26 publications

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“…In our patients' cases VSR was detected 24 and 48 hours respectively after AMI onset which indicates the trend towards an earlier occurrence of the VSR [1]. Since the introduction of myocardial reperfusion therapies the incidence of AMI-related VSR has been reduced to 0,25-0,7% [3].…”

Section: Discussionsupporting

confidence: 56%

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Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Therapeutic Strategy to Choose?

Polak¹,

Jander²,

Kidawa³

et al. 2017

J Clin Exp Cardiolog

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Ventricular septal rupture is still a rare but often fatal complication of acute myocardial infarction. Emergent surgical closure of postinfarction ventricular septal rupture irrespective of the clinical status has been the standard treatment so far. A percutaneous approach using an occluder device is a less invasive option and allows immediate complete closure after initial hemodynamic stabilization. Furthermore immediate reduction of the left-to-right shunt, even if the ventricular septal rupture is not completely closed, may stabilize the patient enough to function as a bridge to surgery. We present two similar cases of patients which highlight the multiple features of acute myocardial infarction-related ventricular septal rupture treated with two alternative techniques.

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Section: Discussionsupporting

confidence: 56%

“…Despite significant improvements in overall mortality for patients with acute myocardial infarction (AMI) the outcome of patients who develop ventricular septal rupture (VSR) remains poor [1][2][3]. Cardiogenic shock and severe left ventricular failure are the most important factors determining the outcome of individuals with VSR [4].…”

Section: Introductionmentioning

confidence: 99%

Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Therapeutic Strategy to Choose?

Polak¹,

Jander²,

Kidawa³

et al. 2017

J Clin Exp Cardiolog

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“…In the era before thrombolytic therapy, it was estimated that PIVSR complicates 1-2% of acute myocardial infarctions (Topaz et al, 1989;Crenshaw et al, 2000). At the present time when acute reperfusion therapy by percutaneous interventions became a routine, the incidence of PIVSR has been estimated about 0.2% of all infarctions (Crenshaw et al, 2000;Yip et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…Medical treatment of PIVSR is usually not efficient (Crenshaw et al, 2000), and early surgical closure of the rupture is recommended (Deja et al, 2000;Labrousse et al, 2002;Yip et al, 2004). However surgical repair is associated with a high rate of mortality even in more recent reports (David et al, 1995;Deja et al, 2000;Labrousse et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Postinfarction Ventricular Septal Rupture – A Rare Complication Remains Challenge for Cardiac Surgical Team

et al. 2013

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R e c e i ve d Ju ly 2 6 , 2 0 1 2 ; A c c e p t e d J a nu a r y 1 5 , 2 0 1 3 . Key words: Myocardial infarction -Ventricular septal rupture -Ventricular assist deviceAbstract: The incidence of post infarction ventricular septal rupture (PIVSR) is decreasing in the last years due to aggressive treatment of myocardial infarction with early percutaneous coronary interventions. As a consequence patients with PIVSR are referred to surgery more often with significant heart failure. The aim of this retrospective study was to assess the influence of these on the operative results and to identify the risk factors of operative mortality. A retrospective analysis of prospectively collected data of patients with the PIVSR admitted to our center from November 2004 to February 2012 was performed. Variables were analyzed using two-dimensional correspondence analysis. There were 25 patients (12 males and 13 females) with mean age 70.2 years (47-82) operated on; 17 (68%) presented with anterior and 8 (32%) with posterior PIVSR. Eighteen patients (72%) had acute heart failure, 13 (52%) presented with cardiogenic shock. Before surgery, intraaortic balloon pump (IABP) had 20 (80%) patients; in 4 (16%) a ventricular assist device was used, either Extracorporeal Membrane Oxygenation (ECMO) or centrifugal pumps as biventricular assist. Operative mortality was 40% (10 pts.). Four patients (12%) had small non-significant recurrent shunt on postoperative echocardiography. Although majority of patients with PIVSR have significant heart failure prior to surgery the operative mortality remains comparable to older studies. Predictors of perioperative death were concomitant surgical reconstruction of the left ventricle, renal impairment before operation, male gender, history of coronary artery disease, PIVSR location posterior, and shock at surgery.

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“…Однако внутрибольничная летальность остается высокой, даже после успешной имплантации окклюдера. чрескожным коронарным вмешательством по сравне-нию с 3% без экстренной реперфузионной терапии; p = 0,0001) [3]. В более ранних исследованиях сообщалось, что постинфарктный дефект межжелудочковой пере-городки обычно возникает в первые 10-14 дней после инфаркта миокарда [4,5].…”

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Endovascular treatment of postinfarction ventricular septal defects

Khelimskii¹,

Крестьянинов²,

Осиев³

et al. 2016

Patol krovoobrashch kardiokhir

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Aim: The study was designed to evaluate the possibility and safety of transcatheter closure of postinfarction ventricular septal defects in different periods after acute myocardial infarction. Methods: Over a period from 2010 to 2015 15 patients (11 females and 4 males) underwent transcatheter closure of postinfarction ventricular septal defects. The time from the onset of infarction to the intervention varied between 1 day and 6 months (mean 10.9 weeks). Three patients were treated in an acute phase of infarction (two weeks or less). The defect size ranged 7-24 mm (mean 13.5 mm), while the implanted devices sized 12-34 mm (mean 22.8 mm). The procedure and screening time amounted to 67-170 (mean 115.3) and 14-78 (mean 32.5) minutes respectively. Results: A successful device implantation occurred in all but one patient whose occluder was dislodged. This patient later underwent successful surgical VSD closure. Occluder implantation failed to improve the clinical status of two patients in a critical condition. They developed multiple organ failure and died at 2 and 9 days after the procedure. Conclusion: Transcatheter closure of postinfarction ventricular septal defects may be an alternative to surgery in patients with suitable anatomy and multiple comorbidities. However, in-hospital mortality remains high, even after successful occluder implantation.

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The Potential Impact of Primary Percutaneous Coronary Intervention on Ventricular Septal Rupture Complicating Acute Myocardial Infarction

Cited by 79 publications

References 26 publications

Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Therapeutic Strategy to Choose?

Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Therapeutic Strategy to Choose?

Postinfarction Ventricular Septal Rupture – A Rare Complication Remains Challenge for Cardiac Surgical Team

Endovascular treatment of postinfarction ventricular septal defects

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