Randomized trial demonstrates effective transcatheter closure in post-infarction patients, highlighting the need for careful patient selection.
BACKGROUND: Postinfarction ventricular septal rupture (PIVSR) is a rare, lethal complication of acute myocardial infarction. Transcatheter device closure offers a less invasive alternative to surgical repair. CASE SUMMARY: We present 4 PIVSR patients after ST-segment elevation myocardial infarction who were successfully managed by transcatheter device closure. Various devices and both retrograde/antegrade techniques with arteriovenous loop formation were employed. While implantations were successful with minimal or no residual shunts, 1 patient died because of severe comorbidities. DISCUSSION: This series highlights the feasibility of diverse transcatheter techniques for PIVSR. It emphasizes successful immediate outcomes but also underscores the critical impact of comorbidities on overall survival in these challenging cases, warranting careful patient selection. TAKE-HOME MESSAGE: Transcatheter PIVSR closure is effective; however, meticulous patient selection and comprehensive multidisciplinary care are crucial given the high comorbidity burden and inherent risks.
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Habib et al. (2026) studied this question.
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