Key result
A hybrid approach combining surgical repair and percutaneous intervention successfully closed a complex post-myocardial infarction ventricular septal defect and stabilized the patient.
Why the study?
Post-myocardial infarction ventricular septal defect is a life-threatening complication associated with high mortality if untreated, and remains challenging to manage despite advances in surgical repair and percutaneous closure.
Case Report (n=1)
No
A hybrid approach combining surgical repair and subsequent percutaneous closure can be an effective salvage strategy for complex post-myocardial infarction ventricular septal defects with residual shunting.
Demonstrates the feasibility of a hybrid strategy for complex post-MI ventricular septal defects;.
BACKGROUND: Post-myocardial infarction ventricular septal defect (post-MI VSD) is a life-threatening complication of acute myocardial infarction, associated with high mortality if untreated. Advances in surgical repair and percutaneous closure have reduced its incidence, but post-MI VSD remains challenging to manage. CASE SUMMARY: A 67-year-old man with an evolved inferior ST-segment elevation myocardial infarction developed cardiogenic shock. After the diagnosis of post-MI VSD, an initial surgical repair was performed. However, residual ventricular septal defect was detected, likely because of patch dehiscence, along with an additional serpiginous septal defect. After discussion within the heart team, a decision was made to proceed with percutaneous closure of the defect using an Amplatzer vascular plug II (Abbott), achieving an excellent clinical outcome. DISCUSSION: A hybrid approach combining surgery and percutaneous intervention for post-MI VSD demonstrates successful outcomes, especially when reoperation poses high risk. This approach could improve management and survival in complex post-MI VSD cases.
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Rizza et al. (2025) conducted a case report in Post-myocardial infarction ventricular septal defect (n=1). Hybrid approach (surgical repair and percutaneous closure) was evaluated on Successful closure of VSD and clinical stabilization. A hybrid approach combining surgical repair and percutaneous intervention successfully closed a complex post-myocardial infarction ventricular septal defect and stabilized the patient.
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