Delayed closure of postinfarction ventricular septum defect in a patient with single vessel disease

• Authors: Pavle Kovacevic , Lazar Velicki , Bojan Vujin
• Languages of publication: EN

Abstracts

EN

A 65-year-old patient with a systolic murmur that developed five days after acute anteroseptal myocardial infarction was referred to our Institution. He had previously been treated with fibrinolytic therapy. The patient was in a stable hemodynamic condition when admitted, with sustained diuresis. Blood gas analysis revealed normal parameters, whereas a chest X-ray showed signs of pulmonary congestion. Transthoracic echocardiography revealed a 1.5×1.2 cm post-infarction ventricular septum defect (VSD) in the apical part of the septum. Because the patient’s hemodynamic conditions were stable, we decided to postpone the operative treatment to allow scarring of the infarcted area to make VSD repair feasible, thereby increasing the chance for success. Operative treatment was performed three weeks after admission. We performed closure of the VSD with a bovine pericardial patch. The patient was discharged in good condition and remained well three months after the surgery.

Keywords

EN

Ventricular septum defect; Acute myocardial infarction; Surgery

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2013
• Volume: 8
• Issue: 5
• Pages: 644-647

Dates

published

1 - 10 - 2013

online

18 - 9 - 2013

Contributors

author

Pavle Kovacevic

author

Lazar Velicki

author

Bojan Vujin

References

• [1] Hutchins GM: Rupture of the interventricular septum complicating myocardial infarction: pathological analysis of 10 patients with clinically diagnosed perforations. Am Heart J 1979; 97: 165–173 http://dx.doi.org/10.1016/0002-8703(79)90351-X[Crossref]
• [2] Lundberg S, Soderstrom J: Perforation of the interventricular septum in myocardial infarction. A study based upon an autopsy material. Acta Med Scand 1962; 172: 413–418 http://dx.doi.org/10.1111/j.0954-6820.1962.tb07174.x[Crossref]
• [3] Mihajlovic B, Nicin S, Cemerlic-Adjic N, et al: Trends of risk factors in coronary surgery. Srp Arh Celok Lek 2010; 138: 570–576 http://dx.doi.org/10.2298/SARH1010570M[Crossref]
• [4] Radford MJ, Johnson RA, Daggett WM, Jr., et al: Ventricular septal rupture: a review of clinical and physiologic features and an analysis of survival. Circulation 1981; 64: 545–553 http://dx.doi.org/10.1161/01.CIR.64.3.545[Crossref]
• [5] David TE, Dale L, Sun Z: Postinfarction ventricular septal rupture: repair by endocardial patch with infarct exclusion. J Thorac Cardiovasc Surg 1995; 110: 1315–1322 http://dx.doi.org/10.1016/S0022-5223(95)70054-4[Crossref]
• [6] Skehan JD, Carey C, Norrell MS, et al: Patterns of coronary artery disease in post-infarction ventricular septal rupture. Br Heart J 1989; 62: 268–272 http://dx.doi.org/10.1136/hrt.62.4.268[Crossref]
• [7] Smyllie JH, Sutherland GR, Geuskens R, et al: Doppler color flow mapping in the diagnosis of ventricular septal rupture and acute mitral regurgitation after myocardial infarction. J Am Coll Cardiol 1990; 15: 1449–1455 http://dx.doi.org/10.1016/S0735-1097(10)80038-5[Crossref]
• [8] Cooley DA, Belmonte BA, Zeis LB, et al: Surgical repair of ruptured interventricular septum following acute myocardial infarction. Surgery 1957; 41: 930–937 [PubMed]
• [9] Anderson DR, Adams S, Bhat A, et al: Postinfarction ventricular septal defect: the importance of site of infarction and cardiogenic shock on outcome. Eur J Cardiothorac Surg 1989; 3: 554–557 http://dx.doi.org/10.1016/1010-7940(89)90118-8[Crossref]
• [10] Madsen JC, Daggett WM, Jr: Repair of postinfarction ventricular septal defects. Semin Thorac Cardiovasc Surg 1998; 10: 117–127 [Crossref][PubMed]
• [11] Dor V, Saab M, Coste P, et al: Left ventricular aneurysm: a new surgical approach. Thorac Cardiovasc Surg 1989; 37: 11–19 http://dx.doi.org/10.1055/s-2007-1013899[Crossref]
• [12] Loisance DY, Lordez JM, Deleuze PH, et al: Acute postinfarction septal rupture: long-term results. Ann Thorac Surg 1991; 52: 474–478 http://dx.doi.org/10.1016/0003-4975(91)90908-9[Crossref]

Identifiers

DOI

10.2478/s11536-012-0127-4