Key result
PCI for anterior MI leads to rare delayed ventricular septal rupture at 16 days.
Why the study?
Delayed ventricular septal rupture after PCI in acute myocardial infarction with recovery of wall motion is a rare and not well characterized complication.
Case Report (n=1)
No
This case highlights the rare occurrence of delayed ventricular septal rupture following successful PCI for acute myocardial infarction, even with a patent infarct-related artery and improved wall motion.
VSR occurred with 90% stenosis; leaves open whether total occlusion is required for septal rupture.
In the era before reperfusion therapy, ventricular septal rupture complicated 1approximate3% of acute myocardial infarctions (AMI) usually 3-5 days after onset. Studies have reported a positive correlation between the incidence of septal perforation and total occlusion of the coronary arteries. A 70-year old female patient was referred to the emergency room with the diagnosis of acute anterior myocardial infarction (MI) and recent cerebral infarction. The coronary angiogram showed a 90% stenosis at the mid-portion of the left anterior descending artery (LAD), and the lesion was successfully treated by percutaneous coronary intervention (PCI) with stent implantation. After PCI, the anterior wall motion improved on the follow-up echocardiogram. However, on the 20th hospital day, the patient condition deteriorated suddenly with pulmonary congestion. The echocardiography revealed a 1.3 cm ventricular septal defect at the apical septum with a left-to-right shunt. We report this rare case of delayed septal rupture in a patient with patent LAD after PCI and recovery of wall motion.
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Park et al. (2005) conducted a case report in Acute Myocardial Infarction (n=1). Percutaneous coronary intervention with stent implantation was evaluated on Delayed ventricular septal rupture. A 70-year-old female developed a rare delayed ventricular septal rupture 16 days after successful percutaneous coronary intervention for acute anterior myocardial infarction.
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