Use of initial biventricular mechanical support in a case of postinfarction ventricular septal rupture as a bridge to surgery

Ann Thorac Surg. 2009 May;87(5):e37-9. doi: 10.1016/j.athoracsur.2009.01.046.

Abstract

The incidence of postinfarction ventricular septal rupture is declining as coronary revascularization techniques have become available for a large number of patients. However, morbidity and mortality rates associated with this complication remain high. We report the case of a patient suffering from acute myocardial infarction who developed a postinfarction ventricular septal defect. Instead of attempting surgical closure, he was placed on biventricular mechanical support. After 2 weeks, surgical closure of the defect and concomitant explantation of the assist device were successfully performed. This approach may represent a new treatment option restoring hemodynamic stability and avoiding surgery on freshly infarcted myocardium.

Publication types

  • Case Reports

MeSH terms

  • Angina, Unstable / complications
  • Echocardiography
  • Echocardiography, Transesophageal
  • Heart Rupture, Post-Infarction / complications*
  • Heart-Assist Devices*
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / surgery*
  • Treatment Outcome
  • Ventricular Septal Rupture / etiology
  • Ventricular Septal Rupture / therapy*