Extract

333 Percutaneous closure of post-myocardial infarction ventricular septal defects: a single center registry

A Biryukov, A Osiev

Research Institute of Circulation Pathology, Novosibirsk, Russian Federation

Background

Ventricular septal rupture occurs in 0.2% of myocardial infarcts and remains associated with very high morbidity and mortality. Surgical repair is difficult because of friable necrotic tissue. Percutaneous closure may be an alternative treatment option in selected patients.

Methods

We report our experience of percutaneous post MI (myocardial infarct) muscular VSDs (ventricular septal defect) closure using the Amplatzer devices. Post MI VSD closure procedures were performed in 13 patients between 2007 and 2011.

Three patients with cardiogenic shock underwent the closure in the acute phase ( < 6 days from the infarct) and 10 cases closure was attempted from 7 to 45 days post-MI.

Results

The procedure was successful in deploying a device across the VSD in 11 of 13 patients. Thirty-day survival was 35%. We have follow up 2 years for 7 patients; all of them are still alive. In two cases the post MI VSD was completely closed. Tree patients had a trivial or small residual shunt, and two patients had a moderate residual shunt.

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