ISSN 1016-5169 | E-ISSN 1308-4488
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Transcatheter ventricular septal rupture closure: A challenging case of basal inferoseptal aneurysm and rupture [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(2): 151-155 | DOI: 10.5543/tkda.2021.96809

Transcatheter ventricular septal rupture closure: A challenging case of basal inferoseptal aneurysm and rupture

Mozhgan Parsaee1, Ata Firouzi2, Raheleh Kaviani3, Azam Soleimani4
1Department of Echocardiography, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
2Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
3Echocardiography Research Center, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
4Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Summary– Ventricular septal rupture (VSR) is an ominous mechanical complication of acute myocardial infarction (MI) accompanied with a poor prognosis. Transcatheter closure (TCC) of VSR has been proposed as an alternative approach for surgery. This study presents a 79-year-old man with diabetes mellitus, hypertension, dyslipidemia, and chronic stable angina with 3-vessel coronary artery disease, who had refused a coronary artery bypass graft. He complained of orthopnea and dyspnea of New York Heart Association (NYHA) function class III after the recent neglected inferior MI. Transthoracic echocardiography revealed moderate left ventricular (LV) systolic dysfunction, true aneurysm formation at the base of the inferoseptal wall, as well as a large-sized (12 mm) VSR at the posterior aspect of basal inferoseptal segment with significant left to right shunt and a peak systolic gradient of 50 mm Hg at the VSR site. Given the high risk profile for surgery and patient refusal, he was a candidate for TCC of VSR and staged multi-vessel percutaneous coronary intervention (PCI). A 30 mm Figulla atrial septal defect (ASD) occluder device was chosen and successfully deployed at the VSR site with minimal residual shunt. A month later, successful multi-vessel PCI was performed with good procedural and clinical outcomes on the 6-month follow-up.

Keywords: Ventricular Septal Rupture, Acute Myocardial Infarction Complication, Septal Occluder Device, Cardiac Aneurysms













How to cite this article
Mozhgan Parsaee, Ata Firouzi, Raheleh Kaviani, Azam Soleimani. Transcatheter ventricular septal rupture closure: A challenging case of basal inferoseptal aneurysm and rupture. Turk Kardiyol Dern Ars. 2021; 49(2): 151-155

Corresponding Author: Azam Soleimani, Iran
Manuscript Language: English


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