Postinfarction VSD with free wall rupture may be successfully salvaged with sequential pVAD and ECMO support as a bridge to surgical repair.
Sequential pVAD-ECMO may stabilize postinfarction VSD with rupture for repair; single case leaves safety and efficacy open to prospective study.
We describe the case of a 54-year-old woman with a postinfarction ventricular septal defect (VSD) and ventricular free wall rupture who was stabilized with a percutaneous ventricular assist device (pVAD) to allow for myocardial infarct stabilization. Following the rupture of the right ventricular free wall and cardiopulmonary arrest on hospital day 10, pVAD support was promptly converted to extracorporeal membrane oxygenation (ECMO) support for stabilization. After surgical repair was completed, pVAD support was continued for 4 days to allow recovery. The patient was discharged on postoperative day 11 and is alive and well 4 years later. Postinfarction VSD with free wall rupture may be salvaged with pVAD and ECMO support.
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Gregorič et al. (2013) studied this question.
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