Key result
Surgical management including VSD repair, mitral valve repair, aneurysm excision, and CABG successfully treated a 49-year-old male with late-presenting MI and mechanical complications.
Case Report (n=1)
Early recognition and comprehensive surgical management of multiple mechanical complications following late-presenting myocardial infarction can achieve successful structural repair and patient recovery.
A 49-year-old diabetic male was admitted to a hospital in 2018 following a 3-week history of worsening dyspnoea and pedal oedema. Early review and investigations indicated acute heart failure. Transthoracic echocardiogram (TTE) revealed mitral regurgitation (MR), aneurysmal change of the ventricles, a ventricular septal defect (VSD) and systolic dysfunction. Coronary angiogram demonstrated a significant left anterior descending and right coronary artery disease. He was diagnosed with a late presenting myocardial infarction (MI) with secondary mechanical complications. Mechanical complications of MI frequently require surgical intervention. The patient underwent a repair of VSD, mitral valve repair, excision of aneurysmal segment and coronary artery bypass grafting. Post-operative recovery was complicated by a sternal wound infection managed in conjunction with the plastic surgeons. A post-operative TTE showed a repaired ventricular septum and no residual MR. Early recognition and appropriate medical optimisation are required to achieve good patient outcomes.
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Belete et al. (2019) conducted a case report in Late presenting myocardial infarction with secondary mechanical complications (n=1). Surgical management (repair of VSD, mitral valve repair, excision of aneurysmal segment and CABG) was evaluated. Surgical management including VSD repair, mitral valve repair, aneurysm excision, and CABG successfully treated a 49-year-old male with late-presenting MI and mechanical complications.
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