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Transcatheter device closure of post-myocardial infarction ventricular septal rupture: A single-centre experience

Praveen Chandra1, Nagendra Singh Chouhan1, Seenu Prasanth Adimoulame1

  • 1Heart Institute, Medanta - The Medicity, Sector 38, Gurugram, Haryana, 122001, India.

Indian Heart Journal
|April 5, 2026
PubMed

Insights

Transcatheter device closure for post-myocardial infarction ventricular septal rupture offers technical success but high early mortality. Patient survival depends on initial physiological status, highlighting the need for careful patient selection.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Post-myocardial infarction ventricular septal rupture is a rare, fatal complication.
  • Cardiogenic shock frequently complicates this condition, increasing mortality risk.

Purpose of the Study:

  • To evaluate the outcomes of transcatheter device closure in surgically declined patients with post-myocardial infarction ventricular septal rupture.
  • To identify factors associated with survival in this high-risk population.

Main Methods:

  • Single-centre retrospective cohort study.
  • Seventeen patients with post-myocardial infarction ventricular septal rupture underwent transcatheter device closure.
  • Data collected on technical success, early mortality, and survival predictors.

Main Results:

  • High technical success rate for device implantation.
  • Substantial early mortality (64.7%) with only 35.3% surviving beyond 30 days.
  • Deaths primarily due to refractory cardiogenic shock and multiorgan failure.

Conclusions:

  • Transcatheter device closure is technically feasible but associated with significant early mortality.
  • Lower SCAI shock stage, preserved lactate clearance, and higher arterial pH predict better survival.
  • Physiological status is critical for patient selection and outcomes in this critical condition.

Keywords:
Cardiogenic shockPost-myocardial infarction ventricular septal ruptureTranscatheter device closure

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