Post-infarction ventricular septal defect: triggered by Valsalva manoeuvre?
Post-infarction ventricular septal defect (VSD) is a fatal mechanical complication of myocardial infarction. Although the incidence has decreased to less than 1% after the extensive use of reperfusion strategies, post-infarction VSD still carries a high mortality risk. Management is controversial, whether to wait for surgery after a stabilisation period or to perform emergency surgery when diagnosed. We report on a case of post-infarction VSD that was detected with severe haemodynamic instability, beginning immediately after the patient's Valsalva manoeuvre on the sixth day of a non-reperfused inferior myocardial infarction. In the early period, the post-infarction VSD was repaired via a trans-aneurismal approach.
Department of Cardiology, Institute of Cardiology, Istanbul University, Haseki, Istanbul. drmuratbaskurt@yahoo.com
M
M
Baskurt
N
N
Turhan
A
A
Hatemi
M
M
Canikoglu
B
B
Karadag
S
S
Kucukoglu
D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D018618:Echocardiography, Doppler, Color; D005260:Female; D006322:Heart Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D014636:Valsalva Maneuver; D018658:Ventricular Septal Rupture / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery