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[Ventricular septal rupture complicating surgically treated left ventricular free wall rupture in a patient with
Szymon Tuchacz1, Rafał Pawlaczyk, Robert Sabiniewicz
1I Klinika Chorób Serca, Instytut Kardiologii, Akademia Medyczna, ul. Debinki 7, 80-211 Gdańsk. szymon.t@amg.gda.pl
Abstract:
There is a group of rare but serious complications of acute myocardial infarction (AMI), including free wall rupture (FWR) and, less frequent, ventricular septal rupture (VSR). Urgent surgery combined with simultaneous CABG is usually a treatment of choice. We present a case of a 65-year-old male with AMI, who developed cardiogenic shock due to cardiac tamponade as a result of FWR. The patient was successfully resuscitated and operated. During postoperative treatment parasternal systolic murmur was audible and VSR diagnosis was confirmed. Three months after AMI the AMPLAZER Muscular VSD Occluder was successfully implanted. The follow-up period was uneventful.
Insights
This case study highlights a rare complication of acute myocardial infarction (AMI): free wall rupture leading to cardiac tamponade. The patient successfully recovered after surgery and subsequent ventricular septal rupture (VSR) closure.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Acute myocardial infarction (AMI) can lead to rare but life-threatening mechanical complications.
- Free wall rupture (FWR) and ventricular septal rupture (VSR) are severe post-AMI complications requiring prompt intervention.
Observation:
- A 65-year-old male presented with AMI complicated by FWR, leading to cardiogenic shock and cardiac tamponade.
- Following successful resuscitation and surgical repair of FWR, a new parasternal systolic murmur indicated a VSR.
Findings:
- The patient underwent successful surgical repair for FWR and was later treated with an AMPLAZER Muscular VSD Occluder for the VSR.
- The VSD occluder implantation was technically successful, with an uneventful follow-up period of three months.
Implications:
- This case demonstrates the successful management of combined FWR and VSR following AMI.
- Percutaneous VSR closure offers a viable therapeutic option for selected patients, complementing surgical interventions.
