Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiography
Abstract Background Post-infarct ventricular septal rupture (PI-VSR) is a rare complication of acute myocardial infarction (AMI) but has very serious implications. Managing PI-VSR using transcatheter closure (TCC) presents varying challenges depending on the patient’s condition. The aim of this stud...
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2025-01-01
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| Series: | The Egyptian Heart Journal |
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| Online Access: | https://doi.org/10.1186/s43044-024-00601-3 |
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| author | Tengku Winda Ardini Yuke Sarastri Joy Wulansari Purba Yasdika Imam Taufik Suci Asriri Ali Nafiah Nasution |
| author_facet | Tengku Winda Ardini Yuke Sarastri Joy Wulansari Purba Yasdika Imam Taufik Suci Asriri Ali Nafiah Nasution |
| author_sort | Tengku Winda Ardini |
| collection | DOAJ |
| description | Abstract Background Post-infarct ventricular septal rupture (PI-VSR) is a rare complication of acute myocardial infarction (AMI) but has very serious implications. Managing PI-VSR using transcatheter closure (TCC) presents varying challenges depending on the patient’s condition. The aim of this study is to present a highly challenging case of multiple VSRs as a complication of AMI. Case presentation: A 59-year-old male was admitted with symptoms of shortness of breath, dyspnea on exertion, orthopnea, and swelling of the lower extremities. He had typical chest pain related to infarction 2 weeks before his admission. On electrocardiogram (ECG) examination, evidence of an old myocardial infarction in the infero-antero-lateral regions was seen. Echocardiography showed mild mitral and tricuspid regularities. The left ventricular (LV) systolic function was mildly compromised, with a global ejection fraction of 44%. There was also a left-to-right VSR shunt in the apical region of the LV. Multiple defects as outlined by 3D transthoracic echocardiography (TTE)—the largest measuring 17 mm. Given the high risks of open-heart surgery, a percutaneous closure of the VSR was carried out using a 21 mm atrial septal defect (ASD) occluder. The device was satisfactorily placed, and there was an improvement in the clinical condition of the patient. He was discharged after his 8-day stay in the hospital. Conclusion Our study emphasizes that echocardiography with 3D imaging provides a more detailed view of the size and shape of the rupture and serves as a valuable modality for guiding the percutaneous transcatheter VSR closure procedure. |
| format | Article |
| id | doaj-art-27099fc1382e41088c5bd33d6f9af87b |
| institution | Kabale University |
| issn | 2090-911X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj-art-27099fc1382e41088c5bd33d6f9af87b2025-01-12T12:28:59ZengSpringerOpenThe Egyptian Heart Journal2090-911X2025-01-017711710.1186/s43044-024-00601-3Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiographyTengku Winda Ardini0Yuke Sarastri1Joy Wulansari Purba2Yasdika Imam Taufik3Suci Asriri4Ali Nafiah Nasution5Cardiovascular Department, Adam Malik General HospitalCardiovascular Department, Adam Malik General HospitalCardiovascular Department, Adam Malik General HospitalDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera UtaraDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera UtaraCardiovascular Department, Adam Malik General HospitalAbstract Background Post-infarct ventricular septal rupture (PI-VSR) is a rare complication of acute myocardial infarction (AMI) but has very serious implications. Managing PI-VSR using transcatheter closure (TCC) presents varying challenges depending on the patient’s condition. The aim of this study is to present a highly challenging case of multiple VSRs as a complication of AMI. Case presentation: A 59-year-old male was admitted with symptoms of shortness of breath, dyspnea on exertion, orthopnea, and swelling of the lower extremities. He had typical chest pain related to infarction 2 weeks before his admission. On electrocardiogram (ECG) examination, evidence of an old myocardial infarction in the infero-antero-lateral regions was seen. Echocardiography showed mild mitral and tricuspid regularities. The left ventricular (LV) systolic function was mildly compromised, with a global ejection fraction of 44%. There was also a left-to-right VSR shunt in the apical region of the LV. Multiple defects as outlined by 3D transthoracic echocardiography (TTE)—the largest measuring 17 mm. Given the high risks of open-heart surgery, a percutaneous closure of the VSR was carried out using a 21 mm atrial septal defect (ASD) occluder. The device was satisfactorily placed, and there was an improvement in the clinical condition of the patient. He was discharged after his 8-day stay in the hospital. Conclusion Our study emphasizes that echocardiography with 3D imaging provides a more detailed view of the size and shape of the rupture and serves as a valuable modality for guiding the percutaneous transcatheter VSR closure procedure.https://doi.org/10.1186/s43044-024-00601-3Multiple ventricular septal rupturesTranscatheter closure3D echocardiographyCase report |
| spellingShingle | Tengku Winda Ardini Yuke Sarastri Joy Wulansari Purba Yasdika Imam Taufik Suci Asriri Ali Nafiah Nasution Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiography The Egyptian Heart Journal Multiple ventricular septal ruptures Transcatheter closure 3D echocardiography Case report |
| title | Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiography |
| title_full | Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiography |
| title_fullStr | Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiography |
| title_full_unstemmed | Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiography |
| title_short | Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiography |
| title_sort | transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction a case report highlighting the role of 3d transthoracic echocardiography |
| topic | Multiple ventricular septal ruptures Transcatheter closure 3D echocardiography Case report |
| url | https://doi.org/10.1186/s43044-024-00601-3 |
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