Background: Ventricular septal rupture (VSR) is a rare mechanical complication following acute myocardial infarction, with very high mortality rate. Haemodynamic deterioration and cardiogenic shock is common in such cases. Rarely, however, patients may show only signs of chronic heart failure or be completely asymptomatic.
Case Summary: We report a case of a 72-year-old male patient with VSR following a transmural myocardial infarction. He sought medical attention only after gradually experiencing symptoms of chronic heart failure, weeks after the onset of the myocardial infarction. The patient successfully underwent elective repair surgery, after optimizing the medical therapy and completing the necessary workup.
Discussion: Ventricular septal rupture repair is necessary in all cases due to the high mortality rate if left untreated. The timing of the operation, however, should be decided individually for every patient. Haemodynamically unstable patients may require early surgery, but in stable patients responding to medical treatment, delayed repair may be the best option.
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http://dx.doi.org/10.1093/ehjcr/ytz047 | DOI Listing |
Indian J Thorac Cardiovasc Surg
February 2025
Department of Cardiovascular Surgery, Abderrahmen Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia.
Infective endocarditis (IE) in children is a rare entity which presents a high rate of events during follow-up. Congenital heart disease, i particular ventricular septal defect (VSD), is the main predisposing condition to IE at those ages. The long-term risk of IE is of concern and whose follow-up can be complicated by a relapse of IE and reintervention.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Department of Cardiovascular Medicine, Richmond Heart & Vascular Associates, Richmond, Virginia, USA.
Transcatheter edge-to-edge repair (TEER) is approved for patients with symptomatic severe mitral regurgitation (MR) who are deemed inoperable or at high surgical risk with life expectancy of more than 1 year, but has also been used off-label in patients with hypertrophic obstructive cardiomyopathy (HOCM) for symptomatic relief who are not candidates for septal reduction therapy. An 83-year-old woman with decompensated heart failure was found to have HOCM with systolic anterior motion of the mitral valve and a large P2 flail segment with ruptured cords. TEER was performed resulting in mild MR and resolution of the prior left ventricular outflow tract gradient.
View Article and Find Full Text PDFReports (MDPI)
December 2024
Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
Unlabelled: The combination of hypertrophic cardiomyopathy with outflow tract obstruction, severe pre-capillary and post-capillary pulmonary hypertension, and severe primary mitral regurgitation is rare and presents distinct management challenges.
Background And Clinical Significance: Pulmonary hypertension is an independent predictor of all-cause mortality in patients with hypertrophic cardiomyopathy managed medically and often precludes patients from undergoing cardiopulmonary bypass due to increased surgical morbidity and mortality. In studies specifically evaluating surgical myectomy, however, survival is favorable in patients with moderate-to-severe pulmonary hypertension.
JACC Case Rep
December 2024
Department of Cardiology, Northern Beaches Hospital, Frenchs Forest, Australia.
A 72-year-old woman underwent left bundle branch area pacing, and subsequent transthoracic echocardiography demonstrated potential septal lead perforation. Transesophageal echocardiography revealed an intracardiac mass, which resolved with anticoagulation. This case highlights left ventricular thrombus as a potential complication of septal lead perforation.
View Article and Find Full Text PDFKardiol Pol
January 2025
Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warszawa, Poland.
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