title: Abrupt progression of ventricular septal perforation after primary angioplasty for acute myocardial infarction.
abstract: A 61-year-old-man was transferred to our hospital because of progressive heart failure after reperfusion for acute myocardial infarction (MI). When he visited the local hospital with severe chest pain associated with inferior MI, transthoracic echocardiography revealed small ventricular septal perforation (VSP). The patient had emergent coronary angiography, which revealed total occlusion of the mid-portion of the right coronary artery. Primary angioplasty was successful for reperfusion. However, because of hemodynamic instability the patient was transferred to our hospital. Under these conditions, transthoracic echocardiography which was undertaken 3 hours after primary angioplasty, demonstrated progressive enlargement of the VSP probably due to reperfusion injury. The rupture site, which was further enlarged at the time of operation, was repaired using the patch exclusion technique. The patient could discharge without complications. We suggest that primary angioplasty may potentially induce late reperfusion injury in patients with VSP complicating MI.
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Nakahashi
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakata
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Toyonobu
authors.initials: T
authors.lastname: Tsuda
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Ohira
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Mori
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Takata
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Masa-Aki
authors.initials: MA
authors.lastname: Kawashiri
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Takemura
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.affiliation: 1 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan ; 2 Department of Internal Medicine, Komatsu City Hospital, Komatsu, Japan ; 3 Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Hayashi
keywords: Echocardiography; mechanical complication; myocardial infarction (MI)