Transcatheter closure of a residual postmyocardial infarction ventricular septal defect with the Amplatzer septal occluder

• Published in: Heart (British Cardiac Society) Vol. 80; no. 5; pp. 522 - 524
• Main Authors: Lee, E M, Roberts, D H, Walsh, K P
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01-11-1998; BMJ; BMJ Publishing Group LTD
• Subjects: Amplazter septal occluder; Biological and medical sciences; Cardiac Catheterization; Case Report; Catheters; Diseases of the cardiovascular system; Echocardiography, Transesophageal; Electrocardiography; Heart attacks; Humans; Male; Medical sciences; Middle Aged; Minimally Invasive Surgical Procedures; Myocardial Infarction - complications; Myocardial Infarction - diagnostic imaging; Prostheses and Implants; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); transcatheter closure; Treatment Outcome; Veins & arteries; ventricular septal defect; Ventricular Septal Rupture - diagnostic imaging; Ventricular Septal Rupture - etiology; Ventricular Septal Rupture - surgery; United Kingdom > UK; Human; Ventricular septal defect; Infarct; Device; Treatment efficiency; Instrumentation therapy; Cardiovascular disease; Intracardiac defect; Instrumental obliteration; Coronary heart disease; Myocardial disease; Case study; Treatment; Heart disease; Myocardium; Complication; Technique
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.80.5.522

Acute ventricular septal rupture following myocardial infarction carries a high mortality. Early surgery improves survival but long term outcome depends on residual shunting and left ventricular function. Residual shunting is common despite apparently successful closure and may require reoperation. Transcatheter closure is an established method of treating selected congenital defects but clinical experience of transcatheter closure in postinfarction ventricular septal rupture is minimal. Transcatheter closure of a residual ventricular septal defect was successfully done using a new device, the Amplatzer septal occluder, in a 50 year old Indian man who had previously undergone emergency surgical repair for postinfarction acute ventricular septal rupture. The technique is described and its potential as a treatment in postinfarction ventricular septal rupture, its possible complications, and the important aspects of case selection and device design are discussed.