HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Szkutnik, M. Articles by Zembala, M. Search for Related Content PubMed PubMed Citation Articles by Szkutnik, M. Articles by Zembala, M. Related Collections Cardiac - other Myocardial infarction

Eur J Cardiothorac Surg 2003;23:323-327
© 2003 Elsevier Science NL

Postinfarction ventricular septal defect closure with Amplatzer occluders

M. Szkutnik^a*, J. Bialkowski^a, J. Kusa^a, P. Banaszak^a, J. Baranowski^a, M. Gsior^b, P. Chodor^c, M. Zembala^d

^a Congenital Heart Defects and Pediatric Cardiology Department, Silesian Centre for Heart Diseases, ul. Szpitalna 2, 41-800 Zabrze, Poland
^b III Cardiology Department, Silesian Centre for Heart Diseases, ul. Szpitalna 2, 41-800 Zabrze, Poland
^c I Cardiology Department, Silesian Centre for Heart Diseases, ul. Szpitalna 2, 41-800 Zabrze, Poland
^d Cardiac Surgery and Transplantology Department, Silesian Centre for Heart Diseases, ul. Szpitalna 2, 41-800 Zabrze, Poland

Received 4 September 2002; received in revised form 5 November 2002; accepted 27 November 2002.

^* Corresponding author
e-mail: jabi_med{at}priv4.onet.pl

Objective: Postinfarction ventricular septal defect (PIVSD) is a rare and life-threatening complication with high risk of both surgical and medical treatment. Another option available now is transcatheter closure. The purpose of this paper is to report the results of such treatment with Amplatzer occluders. Method: Seven patients aged from 51 to 71 years were included. The procedure was performed between 2 and 10 weeks after myocardial infarction. One patient had double residual VSD (2 months after previous surgery) and another, coexisting critical stenosis of right coronary artery (RCA). All patients were in III/IV NYHA class, on intropes, one patient on aortic balloon counterpulsation. Venous jugular approach was used to close the VSD in six patients, venous transfemoral in one patient. Implantation of six Ampaltzer atrial septal occluders (ASO) and one muscular Amplatzer VSD occluder (VSO) were performed. Results: All procedures but two were finished successfully. In one patient, the defect could not be entered neither from the venous nor the arterial side due to unusual oblique course (which was confirmed during subsequent operation). In the second patient (2 weeks after MI), the reason was unstable position of 24 mm ASO (probably due to necrotic borders of VSD). Immediate significant clinical improvement was achieved in all patients, in whom PIVSD was closed with Amplatzer occluders. In one postsurgical patient, two ASO were used; in another patient, prior to VSD closure, PTCA and stent implantation to RCA was performed. The stretched diameter of PIVSD ranged from 8 to 22 mm, the size of implanted Amplatzer occluders from 12 to 24 mm. Fluoroscopy time was 60 min (18–120). During the procedure, ventricular fibrillation requiring defibrillation was observed in three patients. One patient died 1 week after the procedure because of multiorgan failure and increasing mitral incompetence (MI). Conclusions: Despite some technical problems, implantation of Amplatzer occluders, is an attractive option of treatment of patients with subacute PIVSD.

Key Words: Postinfarction ventricular septal defect • Thranscatheter closure • Amplatzer

This article has been cited by other articles:

				H. Thiele, C. Kaulfersch, I. Daehnert, M. Schoenauer, I. Eitel, M. Borger, and G. Schuler Immediate primary transcatheter closure of postinfarction ventricular septal defects Eur. Heart J., January 1, 2009; 30(1): 81 - 88. [Abstract] [Full Text] [PDF]

				S. H. Poulsen, M. Praestholm, K. Munk, P. Wierup, H. Egeblad, and J. E. Nielsen-Kudsk Ventricular Septal Rupture Complicating Acute Myocardial Infarction: Clinical Characteristics and Contemporary Outcome Ann. Thorac. Surg., May 1, 2008; 85(5): 1591 - 1596. [Abstract] [Full Text] [PDF]

				A. K. Agnihotri, J. C. Madsen, and W. M. Daggett Jr Surgical Treatment of Complications of Acute Myocardial Infarction: Postinfarction Ventricular Septal Defect and Free Wall Rupture Card. Surg. Adult, January 1, 2008; 3(2008): 753 - 784. [Full Text]

				V. S. Costache, O. Chavanon, H. Bouvaist, and D. Blin Early Amplatzer occluder closure of a postinfarct ventricular septal defect as a bridge to surgical procedure Interactive CardioVascular and Thoracic Surgery, August 1, 2007; 6(4): 503 - 504. [Abstract] [Full Text] [PDF]

				A. Murday Optimal management of acute ventricular septal rupture Heart, December 1, 2003; 89(12): 1462 - 1466. [Full Text] [PDF]