Ventricular septal defect after acute myocardial infarction

Loisance, D; Cachera, J P; Poulain, H; Aubry, P; Juvin, A.M.; Galey, J J

doi:10.1016/s0022-5223(19)37829-8

Cited by 60 publications

(11 citation statements)

References 9 publications

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“…In patients with hemodynamic instability and higher surgical risk, TCC could serve as a less invasive management option although we found no difference in mortality between those who had early TCC as compared with early surgical repair (54 ± 32% vs 56 ± 23% respectively, P = 0.82). One of the most common factor associated with the poor outcomes of PIVSD closure is the presence of cardiogenic shock; however, if not treated with TCC or surgical repair, the mortality rate approaches 100%. Use of intra‐aortic balloon pump (IABP) can provide initial stabilization and could be used for hemodynamic support prior to closure of PIVSD either surgically or with TCC .…”

Section: Discussionmentioning

confidence: 99%

Management of post‐myocardial infarction ventricular septal defects: A critical assessment

Omar

Morgan

Panchal

et al. 2018

J Interven Cardiology

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Background: Post-myocardial infarction (MI) ventricular septal defects (PIVSD) are an uncommon but life-threatening complication of acute MI. Although surgical closure has been the standard of care, mortality, and recurrence of VSD remain high even after emergent surgery. Transcatheter VSD closure (TCC) devices have become an alternative or adjunct to surgical closure.Methods: Online database search was performed for studies that included adults with PIVSD who underwent medical treatment (MT) alone, surgical closure (SC) (early or late), and TCC (early, late, or for post-surgical residual VSD).Results: Twenty-six studies were included with a total of 737 patients who underwent either MT (N = 100), SC (early (n = 167), late (n = 100)), and TCC (early (n = 176), late (n = 115), or post-surgical residual VSD (n = 79)). The 30-day mortality among MT group was 92 ± 6.3%, among SC was 61 ± 22.5% (early 56 ± 23%, late 41 ± 30%), and for all TCC patients was 33 ± 24% (early 54 ± 32.7%, late 16 ± 26%), and TCC for post-surgical residual VSD 11 ± 34.9%. The mortality among overall SC, overall TCC and early TCC groups was significantly lower as compared with the MT (P < 0.001 for all comparisons).The overall mortality among all TCC, and late TCC groups was significantly lower when compared with the late SC (P < 0.0001, P < 0.0001, respectively). Conclusion: Closure of PIVSD decreases mortality as compared with MT alone and should be attempted as early as possible after diagnosis. Selection of TCC versus SC should be based on factors including complexity of the defect, availability of closure devices, expertise of the operator, and clinical condition of patient. K E Y W O R D S closure device, management, post-infarction VSD, transcatheter

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Section: Discussionmentioning

confidence: 99%

Management of post‐myocardial infarction ventricular septal defects: A critical assessment

Omar

Morgan

Panchal

et al. 2018

J Interven Cardiology

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“…A delay in repair for 6 to 8 weeks results in an improved early mortality, but the cost is the death of a number of patients who might otherwise be salvaged by early operation. The current approach in most units, therefore, is to consider ventricular septal rupture as a surgical emergency 6 – 8 ) .…”

Section: Discussionmentioning

confidence: 99%

“…Postinfarction septal rupture has a poor prognosis when treated conservatively. Septal rupture after infarction should be considered for surgical repair unless a compelling reason exists to suggest otherwise 6 – 8 ) . Pseudoaneurysm of the left ventricle in even asymptomatic patients or small-sized aneurysms, tend to rupture 9 ) .…”

Section: Introductionmentioning

confidence: 99%

Successful Management of Mechanical Complications Following Acute Myocardial Infarction -A Case Report-

Park

Nam

Lee

et al. 1991

Korean J Intern Med

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Rupture of the heart as a complication of myocardial infarction is one of the most common causes of in-hospital mortality. Rupture of the free wall of the ventricle or interventricular septum has a poor prognosis when treated conservatively. So, rupture of the heart after infarction requires prompt diagnosis and early surgical repair despite the high overall incidence of early operative mortality before hemodynamic deterioration and multiorgan failures develop. Rupture of the left ventricle results in pseudoaneurysm if the overlying pericardium adhers to the surface of the heart. Pseudoaneurysms which rarely develop after infarction, tend to rupture. Their presence alone is an indicator for operation because of the very poor prognosis following rupture.We experienced successful management of 2 rare complications after acute myocardial infarction: ventricular septal defect and pseudoaneurysm. The first patient was a 49-year-old man who had an apical septal defect. His electrocardiogram showed Q wave in leads V2–V6, II, III, and aVF but a coronary angiogram showed normal findings. He was successfully treated by patch closure of the septal defect.The second patient was a 65-year-old female who had false aneurysm of the left ventricle. She had neither chest pain nor abnormality on the electrocardiogram. A coronary angiogram showed complete occlusion of the distal circumflex artery. Under cardiopulmonary bypass, the neck of the aneurysmal sac was successfully closed with a prolene suture.

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“…IABP versus Impella™: Die miniaturisierte intrakardiale Blutpumpe Impella Recover LP 2.5™ ist eine intravaskulär gelegene, mikroaxiale Pumpe mit einem maximalen Außendurchmesser von 4 mm ( 58 Gold berichtete bereits 1973 über seine positiven Erfahrungen mit dem Einsatz der IABP bei Patienten mit infarktbedingtem kardiogenen Schock mit VSD (n ¼ 5) und MI (n ¼ 6). In allen Patienten konnte eine deutliche hämodynamische Stabilisierung erreicht werden mit einer Reduktion 131 Während zunächst einige Arbeitsgruppen von einem nur kurz anhaltenden stabilisierenden Effekt der IABP und einer signifikanten hämodynamischen Verschlechterung nach 24h berichteten 93,143,198 konnten andere Arbeitsgruppen einen längerfristigen stabilisierenden Effekt der IABP nachweisen. 16,79,230 Allerdings konnte bisher keine Studie einen Überlebensvorteil der IABP-Therapie beim Infarkt-VSD nachweisen.…”

Section: Metaanalysenunclassified

S3-Leitlinie „Einsatz der intraaortalen Ballongegenpulsation in der Herzchirurgie“

Pilarczyk

Bauer

Boening

et al. 2015

Thorac cardiovasc Surg

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Although intra-aortic balloon pumping (IABP) is the most frequently used mechanical cardiac assist device in cardiothoracic surgery, there are only guidelines for substantive sections of aortic counterpulsation including prophylactic and postoperative use. In contrast, evidence-based recommendations are still lacking concerning intraoperative use, management, contraindication and other relevant issues. According to international surveys, important aspects of IABP usage show a wide variation in clinical practice. The results of a national questionnaire performed before initiation of this guideline confirmed these findings and demonstrated a clear need for the development of a consensus-based guideline. Therefore, the presented multidisciplinary S-3-guideline was developed under the direction of the German Society for Thoracic and Cardiovascular Surgery (Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, DGTHG) to make evidence-based recommendations for the usage of aortic counterpulsation after cardiothoracic surgery according to the requirements of the Association of the Scientific Medical Societies in Germany (AWMF) and the Medical Centre for Quality (Ärztliches Zentrum für Qualität - (ÄZQ)). Main topics discussed in this guideline involve IABP support in the prophylactic, preoperative, intraoperative and postoperative setting as well as the treatment of right heart failure, contraindications, anticoagulation, monitoring, weaning, and limitations of IABP therapy. The presented 15 key messages of the guideline were approved after two consensus meetings under moderation of the AWMF with participation of the German Society of Cardiology (DGK), German Society of Anaesthesiology and Intensive Care Medicine (DGAI), German Interdisciplinary Association for Intensive Care (DIVI) and the German Society for Cardiovascular Engineering (DGfK).

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Ventricular septal defect after acute myocardial infarction

Cited by 60 publications

References 9 publications

Management of post‐myocardial infarction ventricular septal defects: A critical assessment

Management of post‐myocardial infarction ventricular septal defects: A critical assessment

Successful Management of Mechanical Complications Following Acute Myocardial Infarction -A Case Report-

S3-Leitlinie „Einsatz der intraaortalen Ballongegenpulsation in der Herzchirurgie“

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