Percutaneous closure of post myocardial infarction ventricular septal rupture - Video
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Overview
The incidence of post-infarction ventricular septum rupture has decreased from 1–2% to 0.25–0.31%. Survival up to 1 month without intervention is 6%. Given high surgical mortality, transcatheter closure has emerged as a potential strategy in selected cases.
Indian data on percutaneous device closure is scarce hence they report in single-center experience with ASD occlude device for closure of post- acute myocardial infarction ventricular septum rupture. The Study is published in Indian Heart Journal.
In the single-center, retrospective, cohort study, patients who underwent transcatheter closure of post-myocardial infarction ventricular septum rupture were included. Primary outcome was mortality rate at 30 days.
Seven patients were included, out pf which 5 patients had anterior wall myocardial infarction (AWMI) & 2 had inferior wall myocardial infarction (IWMI). None of the patients received thrombolytic therapy.
Device was successfully placed in 5 patients (71.4%) with minimal residual shunt in 2 patients (40%). Out of 7 cases 2 patients survived (29% survival rate). Cardiogenic shock, inferior wall myocardial infarction and serpiginous form of ventricular septum rupture were associated with poor outcomes. Delayed revascularization (PCI) was associated with better outcomes.
Percutaneous closure is a potential technique in a selected group of patients. The presence of cardiogenic shock, inferior wall myocardial infarction and serpiginous form of ventricular septum rupture constitutes important risk factors for mortality. Device implantation is in general successful with few procedure-related complications and should be applied on a case-by-case basis.
Reference: Premchand RK, Garipalli R, Padmanabhan TN, Manik G. Percutaneous closure of post-myocardial infarction ventricular septal rupture - A single centre experience. Indian Heart J. 2017 Apr;69 Suppl 1(Suppl 1):S24-S27. doi: 10.1016/j.ihj.2016.10.004. Epub 2016 Nov 1. PMID: 28400035; PMCID: PMC5388014.
Speakers
Dr. Nandita Mohan
BDS, MDS( Pedodontics and Preventive Dentistry)
Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751