title: A perilous course following myocardial infarction: ischaemic ventricular septal defect in a transplanted heart.
abstract: Coronary artery disease in the donor heart is an established cause of early graft failure. However, identification of this before implantation is difficult. Cardiogenic shock associated with significant myocardial infarction during the early postoperative period is rare. Here, we report a case of a 42-year-old man who presented acutely with cardiogenic shock; he was supported by short-term extracorporeal support as a bridge to transplantation. Following successful orthotopic heart transplantation, he sustained coronary artery atheromatous plaque rupture, resulting in acute coronary artery occlusion, and subsequently developed an ischaemic ventricular septal defect on the third postoperative day.
authors.affiliation: Department of Cardiac Surgery, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Eshan L
authors.initials: EL
authors.lastname: Senanayake
authors.affiliation: Department of Cardiac Anaesthesia, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Harjot
authors.initials: H
authors.lastname: Singh
authors.affiliation: Department of Cardiac Surgery, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Ranasinghe
authors.affiliation: Department of Cardiac Surgery, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK jorge.mascaro@uhb.nhs.uk.
authors.forename: Jorge
authors.initials: J
authors.lastname: Mascaro
mesh_terms: D000328:Adult; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis; D054059:Coronary Occlusion / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D046148:Donor Selection; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000209:etiology; D013997:Time Factors; D018658:Ventricular Septal Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
keywords: Atheromatous plaque; Heart transplant; Myocardial infarction; Ventricular septal defect