Percutaneous Ventricular Assist Device and Extracorporeal Membrane Oxygenation Support in a Patient with Postinfarction Ventricular Septal Defect and Free Wall Rupture

  • Igor D. Gregoric
  • Tomaz Mesar
  • Biswajit Kar
  • Sriram Nathan
  • Rajko Radovancevic
  • Manish Patel
  • Pranav Loyalka

Abstract

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.

References

Birnbaum Y, Fishbein MC, Blanche C, Siegel RJ. 2002. Ventricular septal rupture after acute myocardial infarction. N Engl J Med 347:1426-32.\nConradi L, Treede H, Brickwedel J, Reichenspurner H. 2009. Use of initial biventricular mechanical support in a case of postinfarction ventricular septal rupture as a bridge to surgery. Ann Thorac Surg 87:e37-9.\nFaber C, McCarthy PM, Smedira NG, Young JB, Starling RC, Hoercher KJ. 2002. Implantable left ventricular assist device for patients with postinfarction ventricular septal defect. J Thorac Cardiovasc Surg 124:400-1.\nFormica F, Corti F, Avalli L, Paolini G. 2005. ECMO support for the treatment of cardiogenic shock due to left ventricular free wall rupture. Interact Cardiovasc Thorac Surg 4:30-2.\nGregoric ID, Bieniarz MC, Arora H, Frazier OH, Kar B, Loyalka P. 2008. Percutaneous ventricular assist device support in a patient with a postinfarction ventricular septal defect. Tex Heart Inst J 35:46-9.\nPatane F, Centofanti P, Zingarelli E, Sansone F, La Torre M. 2009. Potential role of the Impella recover left ventricular assist device in the management of postinfarct ventricular septal defect. J Thorac Cardiovasc Surg 137:1288-9.\nRohn V, Spacek M, Belohlavek J, Tosovsky J. 2009. Cardiogenic shock in patient with posterior postinfarction septal rupturesuccessful treatment with extracorporeal membrane oxygenation (ECMO) as a ventricular assist device. J Card Surg 24:435-6.\nSamuels LE, Holmes EC, Thomas MP, et al. 2001. Management of acute cardiac failure with mechanical assist: experience with the Abiomed BVS 5000. Ann Thorac Surg 71(suppl):S67-72; discussion S82-5.\nSibal AK, Prasad S, Alison P, Nand P, Haydock D. 2010. Acute ischaemic ventricular septal defecta formidable surgical challenge. Heart Lung Circ 19:71-4.\nThiele H, Lauer B, Hambrecht R, et al. 2003. Short- and long-term hemodynamic effects of intra-aortic balloon support in ventricular septal defect complicating acute myocardial infarction. Am J Cardiol 92:450-4.\n
Published
2013-06-26
How to Cite
Gregoric, I., Mesar, T., Kar, B., Nathan, S., Radovancevic, R., Patel, M., & Loyalka, P. (2013). Percutaneous Ventricular Assist Device and Extracorporeal Membrane Oxygenation Support in a Patient with Postinfarction Ventricular Septal Defect and Free Wall Rupture. The Heart Surgery Forum, 16(3), E150-E151. https://doi.org/10.1532/HSF98.20121123
Section
Articles

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