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The effectiveness of extracorporeal membrane oxygenation in a patient with post myocardial infarct ventricular septal defect

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ABSTRACT

Background: Post infarction ventricular septal defect (VSD) is an uncommon but life threatening complication of acute myocardial infarction.

Case presentation: A 62-year-old woman was admitted with acute myocardial infarction (AMI). However, the day after angioplasty and stenting, Transthoracic echocardiography (TTE) showed post infarction VSD. We decided to insert an extracorporeal membrane oxygenation (ECMO) device for stabilization purposes before surgical repair. After 4 days from the implantation, we performed surgical repair successfully.

Conclusions: When optimal medical treatment fails to stabilize a patient in cardiogenic shock, peripheral ECMO could be used as a bridge to definitive surgical therapy.

No MeSH data available.


Preoperative echocardiographic findings. a TTE in four chamber view showing a 15 mm VSD in the apicoanterior ventricular septum with left to right shunt. b Color flow Doppler image showing the 8 mm VSD in the mid anterior ventricular septum
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Fig1: Preoperative echocardiographic findings. a TTE in four chamber view showing a 15 mm VSD in the apicoanterior ventricular septum with left to right shunt. b Color flow Doppler image showing the 8 mm VSD in the mid anterior ventricular septum

Mentions: Transthoracic echocardiography (TTE) with Doppler showed an akinetic area in the apex, an ejection fraction of 43 %, and confirmed 15 mm and 8 mm VSDs in the apicoanterior and mid anterior ventricular septum (Fig. 1). Tricuspid regurgitation was mild with moderate pulmonary arterial hypertension with systolic pulmonary artery pressure of 50 mmHg. The total pulmonary to total systemic blood flow ratio (Qp/Qs) of VSD was 5.7.Fig. 1


The effectiveness of extracorporeal membrane oxygenation in a patient with post myocardial infarct ventricular septal defect
Preoperative echocardiographic findings. a TTE in four chamber view showing a 15 mm VSD in the apicoanterior ventricular septum with left to right shunt. b Color flow Doppler image showing the 8 mm VSD in the mid anterior ventricular septum
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5037617&req=5

Fig1: Preoperative echocardiographic findings. a TTE in four chamber view showing a 15 mm VSD in the apicoanterior ventricular septum with left to right shunt. b Color flow Doppler image showing the 8 mm VSD in the mid anterior ventricular septum
Mentions: Transthoracic echocardiography (TTE) with Doppler showed an akinetic area in the apex, an ejection fraction of 43 %, and confirmed 15 mm and 8 mm VSDs in the apicoanterior and mid anterior ventricular septum (Fig. 1). Tricuspid regurgitation was mild with moderate pulmonary arterial hypertension with systolic pulmonary artery pressure of 50 mmHg. The total pulmonary to total systemic blood flow ratio (Qp/Qs) of VSD was 5.7.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Post infarction ventricular septal defect (VSD) is an uncommon but life threatening complication of acute myocardial infarction.

Case presentation: A 62-year-old woman was admitted with acute myocardial infarction (AMI). However, the day after angioplasty and stenting, Transthoracic echocardiography (TTE) showed post infarction VSD. We decided to insert an extracorporeal membrane oxygenation (ECMO) device for stabilization purposes before surgical repair. After 4 days from the implantation, we performed surgical repair successfully.

Conclusions: When optimal medical treatment fails to stabilize a patient in cardiogenic shock, peripheral ECMO could be used as a bridge to definitive surgical therapy.

No MeSH data available.