title: Non-surgical repair of ventricular septal rupture after acute myocardial infarction.
abstract: BACKGROUND
  Ventricular septal rupture (VSR) following myocardial infarction is a rare complication with high mortality. Although transcatheter closure has emerged as a less invasive method of VSR closure, the optimal timing and technique remain unclear.
  
  
  METHODS
  This is a single-center, retrospective, cohort study. Eleven patients that underwent transcatheter closure of post-AMI VSR from 2006 to 2013 at the Second Xiangya Hospital were included in this study. The clinical, procedural, and outcome data were analyzed.
  
  
  RESULTS
  VSR occurred in 4 patients at anterior, 4 at posterior, and 3 at apical ventricular septum. Atrial Septal Defect occluder was used in 2 patients, muscular Ventricular Septal Defect occluder was used in 6 patients, and Patent Ductus Arteriosus occluder was used in 3 patients. The median time between VSR diagnosis and transcatheter closure was 18 days (range, 13-30 days). The median size of the VSR was 12 mm (range, 8-17 mm). The occlusion device was deployed successfully in 10 of 11 patients. Three patients died between zero and seven days after the procedure (30-day mortality, 27.3%). Eight patients survived during a follow-up of 150-1960 days. A follow-up TTE showed no residual shunt in three patients and a trivial or small residual shunt in five patients.
  
  
  CONCLUSIONS
  Transcatheter closure of post-AMI VSR using Atrial Septal Defect, Ventricular Septal Defect, and Patent Ductus Arteriosus occluders is feasible and effective. If the clinical conditions permit, intervention can be delayed to the late phase (>2-3 weeks) after VSR diagnosis.
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Liang
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China. Electronic address: zhenfeifang0829@gmail.com.
authors.forename: Zhenfei
authors.initials: Z
authors.lastname: Fang
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Xinqun
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Jiangjun
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Xiangqian
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Yanshu
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Shenghua
authors.initials: S
authors.lastname: Zhou
mesh_terms: D000368:Aged; D000792:Angiography; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome; D018658:Ventricular Septal Rupture / Q000209:etiology / Q000628:therapy*
keywords: Acute myocardial infarction; Mortality rate; Transcatheter closure; Ventricular septal rupture