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Challenges in treatment of postinfarction ventricular septal defect and heart failure

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Challenges in treatment of postinfarction ventricular septal defect and heart failure. / Mangovski, Ljupčo; Kozlik-Feldmann, Rainer; Perić, Miodrag; Jovović, Ljiljana; Farkić, Mihajlo; Dekić, Dragica.

In: VOJNOSANIT PREGL, Vol. 72, No. 1, 01.2015, p. 68-71.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Mangovski, L, Kozlik-Feldmann, R, Perić, M, Jovović, L, Farkić, M & Dekić, D 2015, 'Challenges in treatment of postinfarction ventricular septal defect and heart failure', VOJNOSANIT PREGL, vol. 72, no. 1, pp. 68-71. https://doi.org/10.2298/vsp1501068m

APA

Mangovski, L., Kozlik-Feldmann, R., Perić, M., Jovović, L., Farkić, M., & Dekić, D. (2015). Challenges in treatment of postinfarction ventricular septal defect and heart failure. VOJNOSANIT PREGL, 72(1), 68-71. https://doi.org/10.2298/vsp1501068m

Vancouver

Mangovski L, Kozlik-Feldmann R, Perić M, Jovović L, Farkić M, Dekić D. Challenges in treatment of postinfarction ventricular septal defect and heart failure. VOJNOSANIT PREGL. 2015 Jan;72(1):68-71. https://doi.org/10.2298/vsp1501068m

Bibtex

@article{1170c042cac146e695121b27189e3e99,
title = "Challenges in treatment of postinfarction ventricular septal defect and heart failure",
abstract = "INTRODUCTION: Acquired ventricular septal defect (VSD) is uncommon, but serious mechanical complication of acute myocardial infarction with poor outcome and high mortality rate in surgically or medically treated patients.CASE REPORT: We report a 58-year-old male patient admitted to our hospital six days following acute inferior myocardial infarction complicated by ventricular septal rupture with signs of heart failure. Coronary angiography revealed 3-vessel disease, with proximally occluded dominant right coronary artery. Transthoracic echo exam revealed aneurysm of a very thin inferior septum and the basal portion of the inferior left ventricular wall, with septal wall rupture. One of the VSD dimensions was 15 mm and left- to right shunt was calculated 2:1. Since the patient was at too high risk for surgical closure, transcatheter closure of VSD was chosen as a better option. Under short intravenous sedation, 24 mm Am- platzer device was implanted percutaneously with transesophageal echo guidance. The post-procedural result revealed a small residual shunt, but it was followed by significant improvement of the patient's clinical status. A 24h Holter ECG monitoring did not show cardiac rhythm or conduction disturbances. Coronary angiography was repeated ten days following the procedure, after hemodynamic stabilization of the patient, with direct stenting of the circumflex artery and the intermediate artery. Ostial left descending artery lesion was left for further functional significance assessment.CONCLUSION: Percutaneous closure with a septal occluder device can be definitive primary treatment for anatomically suitable patients or it can serve as a bridge to surgical treatment.",
keywords = "Coronary Angiography, Echocardiography, Electrocardiography, Ambulatory, Heart Failure/etiology, Heart Rupture/etiology, Heart Septal Defects, Ventricular/etiology, Humans, Male, Middle Aged, Myocardial Infarction/complications, Percutaneous Coronary Intervention, Septal Occluder Device",
author = "Ljup{\v c}o Mangovski and Rainer Kozlik-Feldmann and Miodrag Peri{\'c} and Ljiljana Jovovi{\'c} and Mihajlo Farki{\'c} and Dragica Deki{\'c}",
year = "2015",
month = jan,
doi = "10.2298/vsp1501068m",
language = "English",
volume = "72",
pages = "68--71",
journal = "VOJNOSANIT PREGL",
issn = "0042-8450",
publisher = "Institut za Vojnomedicinske Naucne Informacije/Documentaciju",
number = "1",

}

RIS

TY - JOUR

T1 - Challenges in treatment of postinfarction ventricular septal defect and heart failure

AU - Mangovski, Ljupčo

AU - Kozlik-Feldmann, Rainer

AU - Perić, Miodrag

AU - Jovović, Ljiljana

AU - Farkić, Mihajlo

AU - Dekić, Dragica

PY - 2015/1

Y1 - 2015/1

N2 - INTRODUCTION: Acquired ventricular septal defect (VSD) is uncommon, but serious mechanical complication of acute myocardial infarction with poor outcome and high mortality rate in surgically or medically treated patients.CASE REPORT: We report a 58-year-old male patient admitted to our hospital six days following acute inferior myocardial infarction complicated by ventricular septal rupture with signs of heart failure. Coronary angiography revealed 3-vessel disease, with proximally occluded dominant right coronary artery. Transthoracic echo exam revealed aneurysm of a very thin inferior septum and the basal portion of the inferior left ventricular wall, with septal wall rupture. One of the VSD dimensions was 15 mm and left- to right shunt was calculated 2:1. Since the patient was at too high risk for surgical closure, transcatheter closure of VSD was chosen as a better option. Under short intravenous sedation, 24 mm Am- platzer device was implanted percutaneously with transesophageal echo guidance. The post-procedural result revealed a small residual shunt, but it was followed by significant improvement of the patient's clinical status. A 24h Holter ECG monitoring did not show cardiac rhythm or conduction disturbances. Coronary angiography was repeated ten days following the procedure, after hemodynamic stabilization of the patient, with direct stenting of the circumflex artery and the intermediate artery. Ostial left descending artery lesion was left for further functional significance assessment.CONCLUSION: Percutaneous closure with a septal occluder device can be definitive primary treatment for anatomically suitable patients or it can serve as a bridge to surgical treatment.

AB - INTRODUCTION: Acquired ventricular septal defect (VSD) is uncommon, but serious mechanical complication of acute myocardial infarction with poor outcome and high mortality rate in surgically or medically treated patients.CASE REPORT: We report a 58-year-old male patient admitted to our hospital six days following acute inferior myocardial infarction complicated by ventricular septal rupture with signs of heart failure. Coronary angiography revealed 3-vessel disease, with proximally occluded dominant right coronary artery. Transthoracic echo exam revealed aneurysm of a very thin inferior septum and the basal portion of the inferior left ventricular wall, with septal wall rupture. One of the VSD dimensions was 15 mm and left- to right shunt was calculated 2:1. Since the patient was at too high risk for surgical closure, transcatheter closure of VSD was chosen as a better option. Under short intravenous sedation, 24 mm Am- platzer device was implanted percutaneously with transesophageal echo guidance. The post-procedural result revealed a small residual shunt, but it was followed by significant improvement of the patient's clinical status. A 24h Holter ECG monitoring did not show cardiac rhythm or conduction disturbances. Coronary angiography was repeated ten days following the procedure, after hemodynamic stabilization of the patient, with direct stenting of the circumflex artery and the intermediate artery. Ostial left descending artery lesion was left for further functional significance assessment.CONCLUSION: Percutaneous closure with a septal occluder device can be definitive primary treatment for anatomically suitable patients or it can serve as a bridge to surgical treatment.

KW - Coronary Angiography

KW - Echocardiography

KW - Electrocardiography, Ambulatory

KW - Heart Failure/etiology

KW - Heart Rupture/etiology

KW - Heart Septal Defects, Ventricular/etiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/complications

KW - Percutaneous Coronary Intervention

KW - Septal Occluder Device

U2 - 10.2298/vsp1501068m

DO - 10.2298/vsp1501068m

M3 - SCORING: Journal article

C2 - 26043595

VL - 72

SP - 68

EP - 71

JO - VOJNOSANIT PREGL

JF - VOJNOSANIT PREGL

SN - 0042-8450

IS - 1

ER -