Key result
CMR successfully characterizes complex post-infarction VSD to guide surgical trans-left ventricular patch repair.
Why the study?
Postmyocardial infarction ventricular septal defect is a rare complication requiring individualized repair decisions based on anatomy and hemodynamics.
Does cardiac MRI improve decision-making for percutaneous versus surgical repair of post-infarction ventricular septal defects?
Case Report (n=1)
Does cardiac MRI improve decision-making for percutaneous versus surgical repair of post-infarction ventricular septal defects?
Cardiac MRI is a valuable imaging tool for characterizing the complex anatomy of post-infarction VSDs to guide individualized surgical or percutaneous repair strategies.
AIM: Postmyocardial infarction ventricular septal defect (VSD) is a rare complication that can lead to rapid hemodynamic patient decompensation. The type of VSD repair relies on several factors including: size, location, timing and surgical expertise. CASE: A 63-year-old man with a ST-elevation myocardial infarction underwent percutaneous coronary intervention of the right coronary artery. A holosystolic murmur was notable postcatheterization, and transthoracic echocardiogram confirmed a VSD. To characterize the VSD, a cardiac MRI demonstrated a large, serpiginous VSD and longitudinal septal tear. Given the anatomic complexity and stable hemodynamics, a surgical trans-left ventricular patch repair was performed. CONCLUSION: We emphasize the importance of cardiac magnetic resonance as a decision-making tool, utilizing imaging to ascertain the anatomy combined with hemodynamics to determine optimal individualized therapy.
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Glovaci et al. (2018) conducted a case report in Postmyocardial infarction ventricular septal defect (n=1). Cardiac MRI was evaluated. Cardiac magnetic resonance imaging successfully characterized a complex post-infarction ventricular septal defect, guiding the decision to perform surgical trans-left ventricular patch repair.
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