Use of initial biventricular mechanical support in a case of postinfarction ventricular septal rupture as a bridge to surgery.
The incidence of postinfarction ventricular septal rupture is declining as coronary revascularization techniques have become available for a large number of patients. However, morbidity and mortality rates associated with this complication remain high. We report the case of a patient suffering from acute myocardial infarction who developed a postinfarction ventricular septal defect. Instead of attempting surgical closure, he was placed on biventricular mechanical support. After 2 weeks, surgical closure of the defect and concomitant explantation of the assist device were successfully performed. This approach may represent a new treatment option restoring hemodynamic stability and avoiding surgery on freshly infarcted myocardium.
Conradi
Lenard
L
Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany. lconradi@uke.de
Treede
Hendrik
H
Brickwedel
Jens
J
Reichenspurner
Hermann
H
D000789:Angina, Unstable / Q000150:complications; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D006342:Heart Rupture, Post-Infarction / Q000150:complications*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D018658:Ventricular Septal Rupture / Q000209:etiology / Q000628:therapy*