title: Surgical treatment of ventricular septal defect following myocardial infarction: a case report.
abstract: Ventricular septal defect after myocardial infarction is a rare but often life-threatening mechanical complication. The keys of management are a prompt diagnosis of ventricular septal defect and an aggressive approach to stabilize patient's hemodynamics. Invasive monitoring, judicious use of inotropes and vasodilators, and an intra-aortic balloon pump are recommended for the optimal support of patient's hemodynamics. The best results are achieved if optimally medically managed patients survive at least 4 weeks before elective surgery necessary for scar formation in a friable infarcted tissue. We report a case of acute myocardial infarction complicated by the rupture of ventricular septum. Instead of attempting an immediate surgical closure of ventricular septal defect, the postponed surgery was successfully performed 3 weeks after the occurrence of ventricular septal defect. Preoperatively, clinical and hemodynamic conditions of the patient were maintained stable with the support of an intra-aortic balloon pump and inotropes.
authors.affiliation: Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Eglė
authors.initials: E
authors.lastname: Ereminienė
authors.forename: Rūta
authors.initials: R
authors.lastname: Jurgaitienė
authors.forename: Rimantas
authors.initials: R
authors.lastname: Benetis
authors.forename: Giedrė
authors.initials: G
authors.lastname: Bakšytė
authors.forename: Giedrė
authors.initials: G
authors.lastname: Stanaitienė
mesh_terms: D000368:Aged; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000150:complications* / Q000000981:diagnostic imaging; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D016896:Treatment Outcome; D014463:Ultrasonography