Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience

Egbe, Alexander C.; Poterucha, Joseph T.; Rihal, Charanjit S.; Taggart, Nathaniel W.; Cetta, Frank; Cabalka, Allison K.; Pollak, Peter; Reeder, Guy S.; Hagler, Donald J.

doi:10.1002/ccd.25989

Cited by 49 publications

(47 citation statements)

References 14 publications

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“…Percutaneous closure of the VSR was initially reported in patients at too high risk for surgical repair due to their recent postinfarction status, advanced age, severe coronary artery disease, haemodynamic instability, and added comorbidity (such as renal failure and diabetes mellitus). Therefore in selected patients, percutaneous closure of VSR can be considered either as an alternative or a bridge to surgical repair [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Firstly, interventional reports are mainly restricted to VSR closure in the chronic and subacute setting, or for residual shunts after initial surgical closure [8,9]. It has not been sufficient data regarding performance of percutaneous closure almost straight after the myocardial infarction acute phase.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore more clinical experience needs to be accumulated from different centers before a consensus can be reached on this issue. Additionally, in most cases the devices used for postinfarction VSR closure are dedicated originally for congenital defects and therefore have some technologic limitations to effectively occlude the anatomically complex postinfarction VSRs [9]. Not only are the postinfarction VSRs larger in size and more complex in their geometry, the rims consists of unhealthy infracted tissue that may cause some difficulties in positioning the occluder.…”

Section: Discussionmentioning

confidence: 99%

“…To make matters even worse, these devices are prone to degenerate over time leading to further increase in VSR size. It may provoke occluding device displacements and consequent secondary trans septal shunts [8,9]. Emergent or early surgical intervention remains main definitive treatment for AMI-related VSR.…”

Section: Discussionmentioning

confidence: 99%

“…Emergent or early surgical intervention remains main definitive treatment for AMI-related VSR. On the other hand as regards classic surgery of VSR, many surgeons recommend the procedure after a 3-4 week delay to allow scarring of the surrounding tissue, which allows firmer anchoring of suture and patch material [6][7][8][9][10]. In case of our second patient the decision of immediate surgical repair of VSR was strictly determined by patient severe state due to cardiogenic shock.…”

Section: Discussionmentioning

confidence: 99%

See 4 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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 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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Percutaneous closure of ventricular septal rupture after myocardial infarction: A retrospective study of 81 cases

Chen

Liu

Zhang

et al. 2023

Clinical Cardiology

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Objective To investigate the efficacy and safety of percutaneous closure of ventricular septal rupture (VSR) after acute myocardial infarction (AMI). Methods This retrospective study included 81 patients who underwent transcatheter closure for postinfarction VSR. We analyzed clinical data from hospitalization and the 30‐day follow‐up, compared clinical data from the survival and death groups, and explored the best closure time and the safety and efficacy of occlusion. The risk factors for death at 30 days were analyzed by logistic regression. Results C‐reactive protein (CRP), white blood cell counts, N‐terminal pro brain natriuretic peptide (NT‐ProBNP), and aspartate aminotransferase were higher in the death group than in the survival group (p < .01), with a higher rate of application of vasoactive drugs, and a shorter time from AMI to operation (p < .05). At 30 days postocclusion, 19 patients (23.5%) had died. The mortality rate was significantly lower for operation performed 3 weeks after AMI than for operation performed within 3 weeks of AMI (12.5% vs. 48%, p < .001). Devices were successfully implanted in 76 patients, with 16 (21.1%) operation‐related complications and 12 (15.8%) valve injuries. Cardiac function improved significantly (p < .001) at discharge (N = 66) and 30 days after procedure (N = 62). Qp/Qs and pulmonary artery systolic pressure decreased significantly, while aortic systolic pressure increased significantly (p < .001). Additionally, EF and LVDd improved (p < .05) after occlusion. Increases in CRP and NT‐ProBNP were risk factors for death at 30 days after closure (p < .05). Conclusion Percutaneous VSR closure can be a valuable treatment option for suitable patients with VSR.

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Coronary Artery Diseases

Yin

Hsiung

2016

Atlas of Perioperative 3D Transesophageal Echocardiography

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he was working as lead researcher in hightech companies SQUID AG and MagScan GmbX (Germany). Currently, he is senior staff scientist in the field of medical cybernetics at International Research and Training Center for ITandS of NAS of Ukraine. He combines clinical work with research, focusing on advanced methods for analysis (including pattern recognition) of electrocardiogram , magnetocardiogram , heart rate variability and implementation of such approaches in clinical routine. His research in these areas has been presented at international congresses (ESC, AHA, ACC and many others) and has appeared in academic journals such as PACE, Clinical Cardiology, Annals of Noninvasive Electrocardiology, European Heart Journal, Biophysics etc. He is the author of the book (together with L. Fainzilberg) , devoted to analysis of ECG in phase space. Dr Nataliia Sydorova was born in Kiev, Ukraine, in 1975. She got University Degree in General Medicine (1999) and earned her PhD in Cardiology (2003) at the Bogomolets National Medical University. She has been working as a cardiologist at Cardiological Clinic of Main Military Clinical Hospital of Ministry of Defence of Ukraine (Kiev) till 2001, and then -at Department of Military Common Practice and Family Medicine of the Ukrainian Military Medical Academy (Kiev). Her current position at this department is Associated Professor. In addition Dr. Sydorova was a Deputy Editor of the 'Journal of the American College of Cardiology. Ukrainian edition' from 2008 till 2010. At the present time she is a Deputy Editor of the 'Therapia. Ukrainian Medical Bulletin' journal (from 2010). She has got 12 patents for an invention and ca. 130 scientific publications.

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Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience

Abstract: Transcatheter closure of post-MI VSD carries a moderate risk of periprocedural complications but low event rates afterwards. By comparison, device closure of non-ischemic VSD has lower periprocedural morbidity but some patients continued to experience AE during follow-up.

Cited by 49 publications

References 14 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?

Percutaneous closure of ventricular septal rupture after myocardial infarction: A retrospective study of 81 cases

Coronary Artery Diseases

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