Echocardiographic Assessment of Ventricular Septal Rupture and Left Ventricular Aneurysm after Inferior and Posterior Myocardial Infarction

Pace, Gianna; Filippone, Gianfranco; Corrado, Egle; Triolo, Fabio; Argano, Vincenzo; Novo, Salvatore

doi:10.4103/jcecho.jcecho_29_17

Cited by 4 publications

(5 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Especially 3D RT TEE is necessary during PC, in guiding the device delivery orientation, and in the postoperative assessment of device proper placement, optimal occluder expansion, and residual shunt. [45]…”

Section: Discussionmentioning

confidence: 99%

Ventricular Septal Defect Complicating Inferior Acute Myocardial Infarction: A Case of Percutaneous Closure

Ferraioli

Santoro

Bellino

et al. 2019

J Cardiovasc Echography

View full text Add to dashboard Cite

Ventricular septal defect (VSD) is one of the most serious mechanical complications of acute myocardial infarction (AMI). Despite the incidence of post-AMI VSD in reperfusion era has reduced from 1%–2% to 0.17%–0.31%, it is a still life-threatening condition with poor prognosis. Surgical VSD closure is considered the best treatment approach since conservative management carries an extremely high mortality rate. Over the last decade, percutaneous transcatheter closure has emerged as an alternative therapeutic strategy for a patient with post-AMI VSD, with outcomes similar to cardiac surgery (30-day mortality 14%–66%). We present a case of inferior AMI complicated by posterobasal VSD and cardiogenic shock successfully treated with percutaneous closure. The role of echocardiography in diagnosis, management, and percutaneous procedure guiding has been emphasized.

show abstract

Section: Discussionmentioning

confidence: 99%

Ventricular Septal Defect Complicating Inferior Acute Myocardial Infarction: A Case of Percutaneous Closure

Ferraioli

Santoro

Bellino

et al. 2019

J Cardiovasc Echography

View full text Add to dashboard Cite

show abstract

“…Найбільш рідкісні випадки АЛШ включають хвороби накопичення глікогену та хворобу Чагаса. У більшості випадків діагноз АЛШ встановлюють за даними рутинних електрокардіографії (ЕКГ) та трансторакальної (ТТЕ) ехокардіографії (ЕхоКГ) [1,[4][5][6][7].…”

unclassified

“…Постінфарктна АЛШ розвивається в найгострішу стадію ГІМ приблизно протягом перших 48 годин від початку ГІМ у близько 55 % хворих. У решти АЛШ може розвиватися протягом перших 2 тижнів ГІМ [1,2,4,6]. АЛШ завжди є наслідком трансмурального ГІМ і частіше розвивається при гострому тромбозі передньої міжшлуночкової гілки (ПМШГ) лівої коронарної артерії (ЛКА), що відповідає її більш частій передньоверхівковій локалізації.…”

unclassified

“…АЛШ завжди є наслідком трансмурального ГІМ і частіше розвивається при гострому тромбозі передньої міжшлуночкової гілки (ПМШГ) лівої коронарної артерії (ЛКА), що відповідає її більш частій передньоверхівковій локалізації. Аневризма лівого шлуночка при ГІМ у басейнах огинаючої гілки (ОГ) ЛКА (задньобокові) або правої коронарної артерії (ПКА), тобто нижньодіафрагмальної локалізації, є нечастими (до 12 %) [6][7][8][9]. При формуванні АЛШ особливу роль відіграють руйнування колагену та загибель кардіоміоцитів, що суттєво зменшує механічну міцність стінки та збільшує її патологічну деформацію в систолу в зоні ГІМ, при цьому в перші 5-10 днів формування гострої АЛШ ризик розриву вільної стінки або міжшлуночкової перегородки з формуванням септального дефекту є найвищим.…”

unclassified

“…Черезстравохідна ЕхоКГ (ЧСЕ) може забезпечити оцінювання функції обох шлуночків та їх виміри, а також оцінювання розмірів АЛШ, значущість шунтування за наявності міжшлуночкового дефекту та наявність ре-шунта після хірургічної корекції. Зокрема це дозволяє тривимірна ЧСЕ з множинними зрізами з метою реконструкції повного об'єму дефекту [6].…”

unclassified

See 2 more Smart Citations

Multimodal Visualization of the Left Ventricular Postinfarction Aneurysms: Current State of the Problem and Own Observation Results

Fedkiv

Potashev

Unitska

et al. 2021

ujcvs

View full text Add to dashboard Cite

Background. Left ventricular aneurysm (LVA) is a complication occurring in 5–10% of acute myocardial infarction (AMI) patients significantly complicating AMI acute stage course and leading to advanced congestive heart failure (CHF) progress. Non-invasive LVA visualization includes echocardiography, cardiac magnetic resonance imaging (MRI), radio-nuclide ventriculography, and multi-slice computed tomography (MSCT). It can also be detected during heart catheteriza-tion by coronary ventriculography (CVG). Each method has its advantages and drawbacks. The aim. To analyze multimodal non-invasive LVA visualization methods (echocardiography and MSCT) in order to establish accuracy of these methods compared to CVG regarding the diagnosis of LVA and LVA thrombosis. Methods. We examined 60 patients after AMI with LVA admitted for surgical revascularization and left ventricular aneurysm resection (LVAR). Control group included 110 patients after AMI prior to revascularization without history of LVA. All the patients underwent CVG, heart MSCT and echocardiography prior to surgery. Results. Mean patients’ age was 60.9±11.4 years (46 [76.7%] men and 14 [23.3%] women, mean LVEF was 42.7±11.1%. Significant CAD according to coronary angiography (CAG) before surgery was proved in 59 (98.3%) pa-tients, and 1 (1.7%) patient had no significant coronary lesions. The majority of patients had anterior LVA localization after AMI in LAD area (57 [95.0%] patients), 2 (3.3%) patients were diagnosed with inferior LVA after AMI in RCA area, and 1 (1.7%) patient had posterior-lateral LVA in Cx area. There was high correlation between LVEF obtained with echo-cardiography and that obtained with MSCT (r=0.955, p<0.0001), although mean LVEF obtained with echocardiography was significantly higher compared to MSCT results (42.7±11.1% vs. 32.7±9.3%, p<0.0001). Comparison of accuracy of the methods in LVA diagnosis showed that MSCT was the most precise method with significantly higher sensitivity compared to CVG and echocardiography (94.9% vs. 75.0%, p=0.002, and 88.0%, p=0.023, respectively), and MSCT significantly ex-ceeded CVG in all diagnostic method accuracy indices. Echocardiography also significantly exceeded CVG in all diagnostic accuracy indices. Comparison of accuracy of the methods in LVA thrombosis diagnosis showed similar results: echocar-diography was much more precise in terms of sensitivity (79.4% vs. 58.8%, p<0.0001) and the rest of indices. MSCT was much more precise in terms of all indices compared to CVG, and also significantly exceeded echocardiography results in terms of sensitivity (97.1% vs. 79.4%, p<0.0001), positive (PPV) (100.0% vs. 93.1%, p=0.0005) and negative predictive value (NPV) (99.1% vs. 93.9%, p=0.0091), integral “area under curve” index (AUC) (0.99 vs. 0.89, p=0.0001) and odds ratio (OR) (3630 vs. 208, p<0.0001). Conclusions. High correlation of LVEF according to echocardiography and MSCT results allows to skip CVG as a global LV contractility evaluation method enabling to reduce the procedure time. The lowest accuracy of CVG in the diagnosis of LVA and LVA thrombosis also allows to reduce the duration and volume of the invasive procedure to selective CAG and to reduce radiation exposure for patients and operators in favor of non-invasive and more accurate methods (MSCT and echocardiography). MSCT is the most accurate method for LVA thrombosis diagnosis, but it is completely comparable to echocardiography in LVA diagnosis per se, making echocardiography the method of choice in screening and stratification of patients after AMI regarding myocardial revascularization only or combined surgical revascularization with LVAR due to its rapidness, low cost and absence of patient-related adverse effects.

show abstract

Comunicación interventricular postinfarto visualizada mediante tomografía computarizada. Revisión del diagnóstico

Villaescusa

Otero

Mataró

et al. 2020

Cirugía Cardiovascular

View full text Add to dashboard Cite

Echocardiographic Assessment of Ventricular Septal Rupture and Left Ventricular Aneurysm after Inferior and Posterior Myocardial Infarction

Cited by 4 publications

References 11 publications

Ventricular Septal Defect Complicating Inferior Acute Myocardial Infarction: A Case of Percutaneous Closure

Ventricular Septal Defect Complicating Inferior Acute Myocardial Infarction: A Case of Percutaneous Closure

Multimodal Visualization of the Left Ventricular Postinfarction Aneurysms: Current State of the Problem and Own Observation Results

Comunicación interventricular postinfarto visualizada mediante tomografía computarizada. Revisión del diagnóstico

Contact Info

Product

Resources

About