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Updated: Jul 9, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Percutaneous closure of post-myocardial infarction ventricular septal defects: a single centre experience
Jamil Ahmed1, Peter N Ruygrok, Nigel J Wilson
1Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. JamilA@adhb.govt.nz
Background:
Ventricular septal defect (VSD) is a serious complication of myocardial infarction (MI), occurring in about 0.2% of cases. Untreated, mortality in high and early surgical repair is difficult because of friable necrotic tissue. Percutaneous closure may be an alternative treatment option in selected patients.
Methods:
We report our complete single centre experience of percutaneous post-MI VSD closure using the Amplatzer device. The VSD was closed under general anaesthesia with fluoroscopic and transoesophageal echocardiographic guidance. Clinical characteristics and outcomes are reported.
Results:
The five patients were aged from 66 to 76 years. Closure was attempted from 1 to 64 days post-MI. VSD closure was performed in two patients after surgical patch dehiscence (infero-apical and infero-basal VSDs). The procedure was successful in four patients, with failure to cross the interventricular septum in one. Thirty-day and 12-month survival was 3/5 (60%); no patient undergoing VSD closure early post-MI survived, whereas 3/3 in whom the procedure was undertaken >14 days post-MI survived, suggesting that it may be appropriate to delay attempts at percutaneous VSD closure after MI.
Conclusion:
Percutaneous VSD closure post-MI appears to be a viable alternative to surgical repair, with favourable outcomes if it can be undertaken >14 days post-infarct.
