Successful percutaneous treatment of recurrent post-infarction ventricular septal rupture using an Amplatzer duct occluder

Abstract

Ventricular septal rupture (VSR) is a rare but critical complication that usually occurs within 1 week after acute myocardial infarction (AMI) [1]. Patients without surgical repair of VSR show a high mortality rate of 76% within 1 month, and emergency surgical repair is necessary. However, the in-hospital mortality rate is still high at 47%, and depends on the patient's preoperative condition [2,3]. Here, we describe the successful transcatheter closure of a recurrent post-infarction VSR using an Amplatzer duct occluder (ADO) in a patient who had undergone emergency surgical repair. Case report A 78-year-old woman was referred to our hospital with cardiogenic shock 2 days after the first episode of chest pain. Upon hospital admission, her blood pressure was 78/52 mmHg and her pulse rate was 104 beats/min. Physical examination revealed internal jugular venous dilatation and a grade 3 pan-systolic murmur at the apex. Her 12-lead electrocardiogram showed ST elevation in leads V2-V5. Echocardiography in the emergency room revealed akinesis in the mid anterior septum and apex, and VSR in the apical interventricular septum with left-to-right shunt

A new dimension to the STEMI-related mortality risk seen in the COVID-19 pandemic era

“…Clinical and echocardiographic recognition of VSR coinciding with electrocardiographic recognition of STEMI ( Table 1 ). In this category there were 42 cases [ [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] ] (28 males) of mean age 67. The period of pre-hospital delay ranged from 6 h to 3 months.…”

Successful repair of recurrent ventricular septal perforation after myocardial infarction using double patch technique via right ventriculotomy: a case report

“…Recently, transcatheter approaches using a VSP occluder have gained popularity due to their less invasive nature. However, this VSP occluder is not commersially available in Japan, and if a patient is unable to undergo catheterization, open surgery becomes necessary [11]. Various methods of heart incision, such as through the left ventricle (LV), right ventricle (RV), or right atrium, provide better options to maximize results based on the specific location and condition of the VSP in each patient.…”

“…Mastery of both RV and LV approaches provides better options based on the location of the VSP in each patient. Recently, although the Amplatzer VSP occluder is not commercially available in Japan and guidelines for treating VSP with other types of Amplatzer devices have not been established, successful reports of percutaneous repair using Amplatzer Septal Occluder (ASO) and Amplatzer Ductal Occluder (ADO) have emerged for high-risk surgical patients with VSPs [11,13].…”

Successful Repair of Recurrent Ventricular Septal Perforation after Myocardial Infarction using Double Patch Technique via Right Ventriculotomy: A Case Report

“…Recently, transcatheter approaches using a VSP occluder have gained popularity due to their less invasive nature. However, this VSP occluder is not yet available in Japan, and if a patient is unable to undergo catheterization, open surgery becomes necessary (12). Various methods of heart incision, such as through the left ventricle (LV), right ventricle (RV), or right atrium, provide better options to maximize results based on the speci c location and condition of the VSP in each patient.…”

“…Mastery of both RV and LV approaches provides better options based on the location of the VSP in each patient. Recently, although the Amplatzer VSP occluder is unavailable in Japan and guidelines for treating VSP with other types of Amplatzer devices have not been established, successful reports of percutaneous repair using Amplatzer Septal Occluder (ASO) and Amplatzer Ductal Occluder (ADO) have emerged for high-risk surgical patients with VSPs (12,16).…”