Ventricular Septal Defect Complicating Inferior Acute Myocardial Infarction: A Case of Percutaneous Closure

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Ventricular septal defect (VSD) is a severe mechanical complication of acute myocardial infarction (AMI).
• While the incidence of post-AMI VSD has decreased in the reperfusion era, it remains a life-threatening condition with high mortality.
• Surgical VSD closure is the traditional treatment, but conservative management has an extremely high mortality rate.

Observation:

• This case report details an inferior AMI complicated by a posterobasal VSD and cardiogenic shock.
• The patient was successfully treated with a percutaneous transcatheter closure procedure.
• Echocardiography played a crucial role in the diagnosis, management strategy, and procedural guidance.

Findings:

• Percutaneous transcatheter closure has emerged as a viable alternative therapeutic strategy for post-AMI VSD.
• Outcomes for percutaneous closure are comparable to traditional cardiac surgery, with a 30-day mortality ranging from 14% to 66%.
• Successful percutaneous closure of a complex VSD in the context of cardiogenic shock was achieved.

Implications:

• Percutaneous closure provides a less invasive option for managing post-AMI VSD, potentially reducing morbidity and mortality.
• This approach may be particularly beneficial for patients with cardiogenic shock, offering a life-saving intervention.
• The critical role of advanced imaging, such as echocardiography, in the successful management of these complex cardiac conditions is highlighted.