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Updated: Nov 12, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Ventricular septal defect complicating delayed presentation of acute myocardial infarction during COVID-19 lockdown:
Matthew C Evans1, Daniel H Steinberg1, John F Rhodes1
1Division of Cardiology, Medical University of South Carolina, 30 Courtenay Drive, 326/MSC 592, Charleston, SC 29425, USA.
Insights
Post-myocardial infarction ventricular septal defects (VSDs) are rare but deadly. Transcatheter repair offers a safe and effective alternative to surgery for these complex cases.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Post-myocardial infarction ventricular septal defects (VSDs) are rare complications.
- These defects are associated with high morbidity and mortality.
- The COVID-19 pandemic may increase their incidence due to delayed acute coronary syndrome management.
Observation:
- A 37-year-old male with coronary artery disease risk factors presented with chest discomfort and heart failure symptoms.
- Echocardiography revealed a large muscular VSD.
- Coronary angiography confirmed an anterior wall infarction.
Findings:
- Transcatheter VSD repair was successfully performed.
- The patient showed rapid clinical improvement post-procedure.
Implications:
- Transcatheter VSD repair is a safe and effective alternative to surgical repair.
- This approach can improve outcomes for patients with post-infarction VSDs.
- Early intervention is crucial for managing mechanical complications of myocardial infarction.
Background:
Post-myocardial infarction ventricular septal defects (VSDs) have become rare in the reperfusion era but remain associated with very high morbidity and mortality. As patients defer prompt evaluation and management of acute coronary syndromes during the COVID-19 global pandemic, the incidence of these and other post-infarction mechanical complications is expected to increase.
Case Summary:
A 37-year-old gentleman with multiple coronary artery disease risk factors presented with intermittent chest discomfort and 1 week of heart failure symptoms. An echocardiogram demonstrated a large muscular VSD and coronary angiography confirmed the presence of an anterior wall infarction. He was subsequently referred for transcatheter VSD repair and showed rapid clinical improvement in his symptoms.
Discussion:
Post-infarction VSDs remain associated with a high degree of morbidity and mortality. Surgical repair of acutely ruptured myocardium can be technically challenging, and transcatheter repair has emerged as a safe and effective alternative.
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