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'Ventricular Septal Rupture'

Kristy T Webster, Teimuraz Apridonidze, Prashanth R Mopala, Ariel E Sherman, Lakshmi N Potakamuri, Daniel R Storms, Alan T Kono, Bibhu D Mohanty
We describe the case of a 68-year-old woman presenting with stress cardiomyopathy (SCM), with concomitant cardiogenic shock, left ventricular outflow tract obstruction, and ventricular septal rupture. These complications have not simultaneously been reported in a single SCM case. The importance of early diagnosis of serial complications of SCM and using mechanical circulatory support as a treatment strategy are highlighted.
February 2019: Canadian Journal of Cardiology
Xianjun Xue, Jing Kan, Jun-Jie Zhang, Nailiang Tian, Fei Ye, Song Yang, Hong Qu, Shao-Liang Chen
BACKGROUND: Differences in the predictors between ventricular septal rupture (VSR) and free wall rupture (FWR) have not been fully studied. Data on the prevalence and clinical outcome of heart rupture are limited. HYPOTHESIS: This study aimed to investigate heart rupture incidence and clinical results in patients with acute myocardial infarction (AMI). METHODS: Of 9265 AMI patients in the MOODY registry between March 1999 and October 2016, a total of 146 were studied...
January 23, 2019: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Fayaz Mohammed Khazi, Faozi Al-Safadi, Yehia Karaly, Nayyer R Siddiqui, Bassil Al-Zamkan, Obaid Aljassim
The development of a myocardial infarction ventricular septal rupture is a rare fatal complication, and the surgical repair is the treatment of choice. In most of the scenarios, the operation will be done as an emergency procedure that carries high mortality. Prognosis of these patients depends on prompt echocardiographic diagnosis and the proactive medical and surgical therapy. More recently, various options have been put forward including the timing for surgery, percutaneous closure devices, and the improved outcome with initial stabilization with medical treatment including mechanical support...
January 2019: Annals of Cardiac Anaesthesia
Tan Li, Fan-Xin Kong, Jun-Li Wang, Jun Yang, Chun-Yan Ma
Right ventricular (RV) wall dissection following ventricular septal rupture related to inferior myocardial infarction (MI) is an extremely rare complication with a high mortality rate. We report the case of a 61-year-old man who was admitted to our hospital because of syncope and intermittent chest pain with a precordial murmur. Transthoracic echocardiography showed a rupture at the basal infero-posterior septum and RV free-wall dissection forming an echolucent cavity that extended beyond the septum and subsequently re-entered into RV chamber...
January 4, 2019: Journal of Clinical Ultrasound: JCU
Kamal Sharma, Komal Shah, Sachin Patil, Riyaz Charaniya, Hussain Bhatia, Jayesh Meniya
Ventricular septal rupture (VSR) is an uncommon but potentially lethal complication of acute myocardial infarction (MI). Its prompt recognition is essential to permit timely institution of corrective measures. The present study was undertaken to assess the diagnostic accuracy of a novel and unique angiographic sign, the 'winking coronary sign (WCS)', for recognizing post-MI VSR. The WCS is defined as partial transient occlusion of the infarct-related culprit artery overlying the site of VSR during ventricular systole with near normal filling in the diastole...
December 2018: Indian Heart Journal
Jan-Thorben Sieweke, Jens Vogel-Claussen, Andreas Martens, Jörn Tongers, Andreas Schäfer, Johann Bauersachs, L Christian Napp
A 66-year-old patient was admitted under continuous resuscitation for pulseless electrical activity. After return of spontaneous circulation ECG showed signs of acute inferior ST-elevation myocardial infarction, and echocardiography showed acute right ventricular failure with a dilated right ventricle. Carotid pulses were present in the absence of femoral pulses. Subsequent computed tomography demonstrated inferior myocardial infarction with ventricular septal rupture and thrombotic occlusion of the thoracic aorta, resulting in a heart-brain-circulation with loss of perfusion downstream of the aortic arch...
2018: Case Reports in Critical Care
Y Q Ni, J J Tang, S Tai, L Tang, X Q Hu, Z F Fang, H W Pan, H Huang, C H Liu, G F Zeng, S H Zhou
Objective: To assess the clinical characteristics and identify the risk factors in the acute myocardial infarction (AMI) patients complicating with ventricular septal rupture (VSR). Methods: A retrospective study was performed on 96 AMI patients complicating with VSR, who were hospitalized in the Second Xiangya Hospital of Central South University, Hunan Provincial Peoples' Hospital, the First Affiliated Hospital of University of South China, the Second Affiliated hospital of University of south China, Xiangtan Central Hospital from December 2007 to May 2017...
December 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Albert Ariza-Solé, José C Sánchez-Salado, Fabrizio Sbraga, Daniel Ortiz, José González-Costello, Arnau Blasco-Lucas, Oriol Alegre, David Toral, Victòria Lorente, Eva Santafosta, Jacobo Toscano, Andrea Izquierdo, Albert Miralles, Ángel Cequier
BACKGROUND: Current guidelines recommend emergency surgical correction in patients with post infarction ventricular septal rupture (PIVSR), but patients with multiorgan failure are commonly managed conservatively because of high surgical risk. We assessed characteristics and outcomes of operated PIVSR patients with or without the use of short-term ventricular assist devices (ST-VADs). We also assessed the impact of a ST-VAD on the performance of surgery. METHODS: We retrospectively analysed all consecutive patients with PIVSR between January 2004 and May 2017...
December 10, 2018: European Heart Journal. Acute Cardiovascular Care
Q I Talukder, M H Rahman, A K Azad, M Z Rahman, P K Chanda, F Ahmed
To review the experience of surgical repair of post-infarction ventricular septal rupture (VSR) and analyze the associated outcomes in National Heart Foundation Hospital & Research Institute (NHFH & RI). This retrospective review was performed on 19 consecutive cases who had undergone surgical repair of post-infarction VSR between 2009 and 2017. Continuous variables were summarized as mean plus/minus the standard deviation or median. Categorical variables were expressed as percentage of the sample. Comparison between in-hospital survivors versus non-survivors was performed by Student's t-test and chi-square or Fisher's exact test for continuous and categorical variables respectively...
October 2018: Mymensingh Medical Journal: MMJ
Norihiko Kamioka, Peter C Block
Review of the Medicare database shows that over the past 16 years the incidence of post- myocardial infarction (MI) ventricular septal rupture (VSR) has decreased but mortality for all post-MI VSR hospitalizations remains unchanged and high During the study period, the 30-day VSR repair rate decreased from 49.9% in 1999 to 33.3% in 2014. Unadjusted mortality was lower for patients undergoing repair procedures than for those not undergoing repair both at 30 days and at 1-year. Most VSR patients underwent surgical repair (82...
November 15, 2018: Catheterization and Cardiovascular Interventions
V Rao Parachuri, Amit Kumar Tripathy, N M Gaikwad, Akshaya Pratap Singh, Vineet Mahajan, S Niranjan
Repair of ventricular septal rupture post acute myocardial infarction remains a surgical challenge. Several techniques for the closure of these defects have been described. We modified the infarct exclusion technique as described by Tirone David. In this technique two separate pericardial patches are used. The first patch excludes the rupture. The second patch is sutured to the margins of the first patch which provides strength to the margins of the first patch. It is simple, durable and has reduced incidence of residual ventricular septal defects and patch dehiscence...
November 4, 2018: Annals of Thoracic Surgery
Homare Okamura, Mamoru Arakawa, Taro Takeuchi, Hideo Adachi
Ventricular septal rupture is an uncommon fatal complication of acute myocardial infarction. In rare cases, the rupture can extend into the right ventricular free wall and cause intramyocardial dissection. We describe the case of a patient who developed postinfarction right ventricular free wall dissection with left-to-right shunting and successfully underwent patch repair.
October 4, 2018: Interactive Cardiovascular and Thoracic Surgery
Tetsuya Nomura, Kenshi Ono, Yu Sakaue, Daisuke Ueno, Yusuke Hori, Kenichi Yoshioka, Masakazu Kikai, Natsuya Keira, Tetsuya Tatsumi
BACKGROUND As primary percutaneous coronary intervention (PCI) has been commonly performed for acute myocardial infarction (AMI), we rarely encounter ventricular septal rupture (VSR), which is one of the mechanical complications of AMI. However, the associated mortality rate is still very high unless treated appropriately. CASE REPORT We encountered a very rare case of VSR that was considered to have occurred during primary PCI for AMI. The manifestation of sudden coronary flow disturbance may correspond with the emergence of VSR...
September 18, 2018: American Journal of Case Reports
Takeshi Ikuta, Noriaki Kishimoto, Hirofumi Fujii, Eiji Kimura, Yoshihiro Shimizu
Ventricular septal rupture(VSR) after acute myocardial infarction(AMI) is a rare and serious complication that is associated with extremely high mortality. Delayed VSR is particularly uncommon and is difficult to diagnose and treat. A 68-year-old man presented with dyspnea on effort. Coronary angiography revealed subtotal occlusion of the right coronary artery(RCA) with collateral circulation to the chronically and totally occluded left anterior descending artery (LAD). Elective stenting of the RCA was successfully performed for a recent MI of the RCA, while percutaneous coronary intervention(PCI) in the LAD ended in failure...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Manav Aggarwal, Kumaraswamy Natarajan, Maniyal Vijayakumar, Rajiv Chandrasekhar, Navin Mathew, Vikrant Vijan, Anjith Vupputuri, Sanjeev Chintamani, Bishnu Kiran Rajendran, Rajesh Thachathodiyl
OBJECTIVE: The study investigated effectiveness of transcatheter closure of post-myocardial infarction (MI) ventricular septal rupture (VSR) using atrial septal device (ASD) occluder in a cohort of patients admitted at our institute. METHOD: This was a retrospective, observational and single center study, which included patients who were treated with transcatheter closure for post-MI VSR at our tertiary care center between May 2000 and August 2014 depending upon inclusion and exclusion criteria...
July 2018: Indian Heart Journal
Akshyaya Pradhan, Nirdesh Jain, Salvatore Cassese, Pravesh Vishwakarma, Rishi Sethi, Sharad Chandra, Gaurav Chaudhary, Sudhanshu Kumar Dwivedi, Varun Shankar Narain
Objective: We sought to investigate the incidence and predictors of 30-day mortality associated with ventricular septal rupture (VSR) complicating acute myocardial infarction (AMI) in a cohort of patients admitted to a single centre in India. Methods: From October 2013 to February 2016, a total of 6560 patients with a diagnosis of AMI were admitted to our institution. Among these patients, those with a diagnosis of VSR were retrospectively included in this registry...
2018: Heart Asia
Takuma Yamasaki, Yuichi Matsuzaki, Yu Hohri, Takeshi Hiramatsu
Ventricular septal rupture with ventricular free wall dissection is an extremely rare complication after inferior myocardial infarction, and the optimal surgical strategy remains unclear because of the limited number of survival cases. Electrocardiography-synchronized contrast computed tomography was performed before surgery to identify the dissected area and to set up a surgical strategy. We report on modified double patch repair with ventricular wall dissection exclusion, which might be effective for preventing residual shunt and maintaining cardiac function...
December 2018: Annals of Thoracic Surgery
Muhammad Yasir Khan, Tariq Waqar, Perisa Gul Qaisrani, Adnan Zafar Khan, Muhammad Shahrukh Khan, Haider Zaman, Anjum Jalal
Background and Objective: Ventricular septal rupture (VSR) is one of the fatal complications of myocardial infarction (MI). Surgery provides the maximum survival benefit. Our objective was to investigate the risk factors of surgical mortality and to do the survival analysis in the past six years at our hospital. Methods: All the patients operated at CPE Institute of Cardiology Multan Pakistan, between 2009 and 2015 for repair of post MI VSR were analysed retrospectively for demographics, comorbidities, operative and post operative outcomes...
January 2018: Pakistan Journal of Medical Sciences Quarterly
Giuliana Pace, Gianfranco Filippone, Egle Corrado, Fabio Triolo, Vincenzo Argano, Salvatore Novo
We present a case of posterior ventricular septal rupture associated to left ventricular aneurysm manged, during peri-operative period, by transthoracic and transesophageal echocardiography. Three-dimensional transesophageal echocardiography findings add adjunctive and more accurate information regarding morphological details of the ventricular septal rupture rather than two-dimensional echocardiography, allowing, meanwhile, the detection of the outcome of the surgical repair.
January 2018: Journal of Cardiovascular Echography
Takahiro Katsumata, Masahiro Daimon, Hayato Konishi, Shinji Fukuhara
BACKGROUND: The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett's original technique of multi-patch repair of ruptured posterior septum. CASE PRESENTATION: The technique was employed in the operation of a 67-year-old male who presented with severe heart failure at the 10th day after he developed inferior myocardial infarction...
March 27, 2018: Surgical Case Reports
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