title: Complicated transcatheter closure of postinfarction ventricular acute septal defect.
abstract: The ventricular septal rupture is an uncommon complication of myocardial infarction (MI) with a reported incidence of 0.2% in the thrombolytic era. The outcome remains extremely poor, and surgical defect closure still remains the only therapeutic option improving survival. There are single reports based on a small series of case reports about transcatheter closure of postinfarction ventricular septal defects (VSD) and experience is limited. We present a case of a 71-year-old man with a posteroinferior MI complicated by a ventricular septal rupture with 24 mm width. Due to the severity of the case, surgical approach was denied; we attempted transcatheter closure of the defect in a lifesaving situation. The VSD was partially closed with a 26 mm Amplatzer® septal occluder (AGA Medical Corp., Plymouth, Minnesota) without adequate expansion of the right disc, due the complexity of the tract. The patient died one day after the procedure.
authors.affiliation: Department of Cardiology of São João Hospital E.P.E., Rua de Francos no. 393 3.1, 4250 - Porto, Portugal. numoreno@yahoo.com
authors.forename: Nuno
authors.initials: N
authors.lastname: Moreno
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Silva
authors.forename: Aurora
authors.initials: A
authors.lastname: Andrade
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000295:instrumentation / Q000379:methods*; D004452:Echocardiography; D017809:Fatal Outcome; D006342:Heart Rupture, Post-Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D055989:Septal Occluder Device