ArticleThe Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology2025
Transcatheter closure of multiple ventricular septal ruptures after acute myocardial infarction: a case report highlighting the role of 3D transthoracic echocardiography.
Article in The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPost-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.
conclusionOur 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.
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