title: Transcatheter device closure of a residual postmyocardial infarction ventricular septal defect.
abstract: Postmyocardial infarction ventricular septal defect (VSD) carries a high mortality and, even after successful surgery, residual defect is common. A 75-year-old woman was admitted with the diagnosis of hyperacute anterior myocardial infarction. Primary percutaneous intervention was performed by stenting of a totally obstructed segment in the proximal left anterior descending artery. The patient's condition deteriorated on the second postprocedural day with a 3/6 pansystolic murmur at the mesocardium. Echocardiography revealed an apical anteroseptal VSD and moderate pulmonary hypertension. She underwent surgical VSD closure with a Gore-Tex patch and coronary artery bypass grafting to the left anterior descending and circumflex arteries. The patient's condition continued to be unstable due to septicemia and hemodynamically significant residual VSD. After medical management of septicemia, the residual defect was successfully closed using a 10-mm Cardio-O-Fix septal occluder under fluoroscopic and transesophageal echocardiographic guidance. The clinical condition of the patient was then stabilized and there was no significant residual shunt on echocardiography on the third postprocedural day.
authors.affiliation: Department of Pediatric Cardiology, Medicana International Hospital, İstanbul, Turkey.
authors.forename: Yalım
authors.initials: Y
authors.lastname: Yalçın
authors.forename: Cenap
authors.initials: C
authors.lastname: Zeybek
authors.forename: Ibrahim Ozgür
authors.initials: IO
authors.lastname: Onsel
authors.forename: Mehmet Salih
authors.initials: MS
authors.lastname: Bilal
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D003937:Diagnosis, Differential; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D055989:Septal Occluder Device; D015607:Stents; D013526:Surgical Mesh; D014463:Ultrasonography