Ventricular Septal Rupture Complicating Acute Myocardial Infarction: Clinical Characteristics and Contemporary Outcome

Poulsen, Steen Hvitfeldt; Præstholm, Michael; Munk, Kim; Wierup, Per; Egeblad, Henrik; Nielsen‐Kudsk, Jens Erik

doi:10.1016/j.athoracsur.2008.01.010

Cited by 96 publications

(90 citation statements)

References 26 publications

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“…In addition, in keeping with other studies, our patients had also other risk factors of VSR including arterial hypertension, lack of previous history of CAD, anterior localization of AMI, single-vessel CAD and delayed treatment after the onset of AMI symptoms [2][3][4][5][6]. This suggests, that pathophysiology of AMI-related VSR involves sudden, severe ischemia, which in turn leads to extensive myocardial necrosis.…”

Section: Discussionsupporting

confidence: 81%

“…The first presented patient was and elderly female with a low BMI, all of which are important independent predictors of AMIrelated VSR [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…The principal treatment of VSR consists of emergency rapid stabilization with inotropic agents and, if necessary, the use of intra-aortic balloon counterpulsation. Early surgery is considered the gold standard for postinfarction VSR, with the high surgical risk being acceptable in the face of the even higher risk of death without surgery [5][6][7]. More recently an additional option of percutaneous closure of the rupture has become available.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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: 81%

“…The first presented patient was and elderly female with a low BMI, all of which are important independent predictors of AMIrelated VSR [4,5].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…Недавние сообщения показа-ли, что время между инфарктом миокарда и развитием дефекта межжелудочковой перегородки укорачивает-ся. В настоящее время дефект межжелудочковой пере-городки развивается в течение 1-й недели после инфар-кта миокарда с более высокой частотой в первые 24 ч и на 3-5-е сутки [6][7][8].…”

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“…Факторы риска: женский пол [5,6,10,11], артериаль-ная гипертензия, отсутствие предшествующих инфарк-тов миокарда либо стенокардии [7].…”

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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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Synopsis of Adult Cardiac Surgical Disease

Bojar

2005

Manual of Perioperative Care in Adult Cardiac Surgery

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Ventricular Septal Rupture Complicating Acute Myocardial Infarction: Clinical Characteristics and Contemporary Outcome

Cited by 96 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?

Endovascular treatment of postinfarction ventricular septal defects

Synopsis of Adult Cardiac Surgical Disease

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