Percutaneous ventricular assist device support in a patient with a postinfarction ventricular septal defect
Complications of acute myocardial infarction have decreased in number and severity due to the application of early thrombolytic coronary revascularization techniques. Nonetheless, the mortality rate associated with these complications remains high. Ventricular septal rupture is one of the complicati...
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Published in | Texas Heart Institute journal Vol. 35; no. 1; pp. 46 - 49 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Texas Heart Institute
2008
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Subjects | |
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Abstract | Complications of acute myocardial infarction have decreased in number and severity due to the application of early thrombolytic coronary revascularization techniques. Nonetheless, the mortality rate associated with these complications remains high. Ventricular septal rupture is one of the complications that can occur after myocardial infarction. In the treatment of postinfarction ventricular septal rupture, the need for immediate closure to avoid acute hemodynamic compromise must be weighed against the need for delayed repair to enable the acutely necrotic myocardium to organize and to develop fibrotic tissue. We report the use of a minimally invasive TandemHeart percutaneous ventricular assist device for 18 days in a 58-year-old man who experienced postinfarction ventricular rupture. The hemodynamic support provided by the device allowed time for left ventricular recovery before attempted percutaneous closure of the ventricular septal rupture and after definitive surgical repair of the septal defect. To our knowledge, this is the 1st reported use of the TandemHeart for support before and after repair of a postinfarction ventricular septal rupture. |
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AbstractList | Complications of acute myocardial infarction have decreased in number and severity due to the application of early thrombolytic coronary revascularization techniques. Nonetheless, the mortality rate associated with these complications remains high. Ventricular septal rupture is one of the complications that can occur after myocardial infarction. In the treatment of postinfarction ventricular septal rupture, the need for immediate closure to avoid acute hemodynamic compromise must be weighed against the need for delayed repair to enable the acutely necrotic myocardium to organize and to develop fibrotic tissue. We report the use of a minimally invasive TandemHeart percutaneous ventricular assist device for 18 days in a 58-year-old man who experienced postinfarction ventricular rupture. The hemodynamic support provided by the device allowed time for left ventricular recovery before attempted percutaneous closure of the ventricular septal rupture and after definitive surgical repair of the septal defect. To our knowledge, this is the 1st reported use of the TandemHeart for support before and after repair of a postinfarction ventricular septal rupture. Complications of acute myocardial infarction have decreased in number and severity due to the application of early thrombolytic coronary revascularization techniques. Nonetheless, the mortality rate associated with these complications remains high. Ventricular septal rupture is one of the complications that can occur after myocardial infarction. In the treatment of postinfarction ventricular septal rupture, the need for immediate closure to avoid acute hemodynamic compromise must be weighed against the need for delayed repair to enable the acutely necrotic myocardium to organize and to develop fibrotic tissue. We report the use of a minimally invasive TandemHeart® percutaneous ventricular assist device for 18 days in a 58-year-old man who experienced postinfarction ventricular rupture. The hemodynamic support provided by the device allowed time for left ventricular recovery before attempted percutaneous closure of the ventricular septal rupture and after definitive surgical repair of the septal defect. To our knowledge, this is the 1st reported use of the TandemHeart for support before and after repair of a postinfarction ventricular septal rupture. |
Author | Gregoric, Igor D Frazier, O H Arora, Harvinder Kar, Biswajit Loyalka, Pranav Bieniarz, Mark C |
AuthorAffiliation | Departments of Cardiopulmonary Transplantation (Drs. Frazier and Gregoric) and Cardiology (Drs. Arora, Bieniarz, Kar, and Loyalka), Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030 |
AuthorAffiliation_xml | – name: Departments of Cardiopulmonary Transplantation (Drs. Frazier and Gregoric) and Cardiology (Drs. Arora, Bieniarz, Kar, and Loyalka), Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030 |
Author_xml | – sequence: 1 givenname: Igor D surname: Gregoric fullname: Gregoric, Igor D email: epongratz@heart.thi.tmc.edu organization: Department of Cardiopulmonary Transplantation, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA. epongratz@heart.thi.tmc.edu – sequence: 2 givenname: Mark C surname: Bieniarz fullname: Bieniarz, Mark C – sequence: 3 givenname: Harvinder surname: Arora fullname: Arora, Harvinder – sequence: 4 givenname: O H surname: Frazier fullname: Frazier, O H – sequence: 5 givenname: Biswajit surname: Kar fullname: Kar, Biswajit – sequence: 6 givenname: Pranav surname: Loyalka fullname: Loyalka, Pranav |
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Keywords | heart septal defects, ventricular/complications/etiology/physiopathology/surgery/therapy time factors intra-aortic balloon pumping heart-assist devices Cardiac surgical procedures myocardial infarction/complications ventricular septal rupture, post-infarction/complications/etiology/surgery hemodynamics shock, cardiogenic/etiology/therapy |
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SubjectTerms | Case Reports Echocardiography, Transesophageal Heart-Assist Devices Humans Male Middle Aged Suture Techniques Ventricular Septal Rupture - diagnostic imaging Ventricular Septal Rupture - physiopathology Ventricular Septal Rupture - surgery Ventricular Septal Rupture - therapy |
Title | Percutaneous ventricular assist device support in a patient with a postinfarction ventricular septal defect |
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