Key result
Percutaneous VSD occluder successfully treats post-surgical perimembranous defect after aortic valve replacement.
Why the study?
The optimal treatment strategy for a post-surgical perimembranous interventricular defect with a clinically significant left-to-right shunt following aortic valve replacement needed to be addressed.
Case Report (n=1)
No
Illustrates the use of percutaneous ventricular septal defect occluder closure to manage a post-surgical perimembranous interventricular defect presenting with heart failure after aortic valve replacement.
Answers are grounded in this paper and cite their sources.
May offer percutaneous option for post-AVR perimembranous VSD; leaves open safety and efficacy in larger series.
BACKGROUND: A 73-year-old man was admitted to our Institute for repeated episodes of congestive heart failure. The patient was affected by arterial hypertension, dyslipidaemia, severe chronic obstructive pulmonary disease, and recurrent atrial fibrillation. Two months earlier he had undergone aortic valve replacement with a biological prosthesis for severe stenosis. Echocardiography showed a left-to-right shunt localised in the left ventricular outflow tract, normal morphology and function of the aortic valve prosthesis, and a hyperkinetic left ventricle. INVESTIGATION: Physical examination, electrocardiography, transthoracic and transoesophageal echocardiography, right heart catheterisation, left ventricular angiography. DIAGNOSIS: Post-surgical perimembranous interventricular defect with a clinically significant left-to-right shunt. MANAGEMENT: Percutaneous closure with a ventricular septal defect occluder.
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Coceani et al. (2012) conducted a case report in Post-surgical perimembranous interventricular defect with left-to-right shunt (n=1). Percutaneous closure with a ventricular septal defect occluder was evaluated. Percutaneous closure with a ventricular septal defect occluder was used to manage a post-surgical perimembranous interventricular defect in a 73-year-old man 2 months after aortic valve replacement.
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