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Published on: June 14, 2015
Innovative Use of Fusion Imaging for Percutaneous Closure of Post-Myocardial Infarction Ventricular Septal Rupture
Mustafa Alkhawam1, Ali J Ebrahimi1, Navin C Nanda1
1Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Background:
Ventricular septal rupture (VSR) post myocardial infarction (MI) is a rare, high-risk complication requiring urgent intervention. Fusion imaging (FI), integrating echocardiography and fluoroscopy, offers a novel approach for percutaneous closure in unstable patients.
Case Summary:
A 60-year-old man developed cardiogenic shock and basal VSR after inferior MI stent placement. Echocardiography confirmed the defect with a left-to-right shunt. Using FI, percutaneous closure with a 16-mm Amplatzer device was completed under real-time guidance. Post-procedure imaging revealed a well-seated device with minimal residual shunt.
Discussion:
Overlaying echocardiographic imaging on fluoroscopy enhances procedural precision and can reduce radiation and procedural time. This case represents FI-guided post-MI VSR closure.
Take-Home Messages:
FI enables rapid, accurate percutaneous procedures in critically ill patients, minimizing procedural time and risks. We present our experience using FI to reduce crossing attempts and improve device deployment accuracy in a critically ill patient with VSR.
