Document Detail


Urgent hybrid approach in treatment of the acute myocardial infarction complicated by the ventricular septal rupture.
MedLine Citation:
PMID:  24839780     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: Ventricular septal rupture (VSR) in the acute myocardial infarction (AMI) is a rare but very serious complication, still associated with high mortality, despite significant improvements in pharmacological and surgical treatment. Therefore, hybrid approaches are introduced as new therapeutical options.
CASE OUTLINE: We present an urgent hybrid approach, consisting of the initial percutaneous coronary intervention (PCI) of the infarct-related artery, followed by immediate surgical closure of the ventricular septal rupture, for treatment of high risk, hemodynamically unstable female patient with AMI caused by one-vessel disease and complicated by VSR and cardiogenic shock. Since the operative risk was also very high (EUROSCORE II 37%), this therapeutic decision was based on the assumption that preoperative PCI could promptly establish blood flow and thereby lessen the risks, duration and complexity of urgent cardiosurgical intervention, performed on the same day. This approach proved to be successful and the patient was discharged from the hospital on the fifteenth postoperative day in stable condition.
CONCLUSION: In selected cases, with high operative risk and unstable hemodynamic state due to AMI complicated by VSR, urgent hybrid approach consisting of the initial PCI followed by surgical closure of VSR may represent an acceptable treatment option and contribute to the treatment of this complex group of patients.
Authors:
Mina Radosavljević-Radovanović; Nebojsa Radovanović; Aleksandra Arandjelović; Predrag Mitrović; Ana Usćumlić; Goran Stanković
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Srpski arhiv za celokupno lekarstvo     Volume:  142     ISSN:  0370-8179     ISO Abbreviation:  Srp Arh Celok Lek     Publication Date:    2014 Mar-Apr
Date Detail:
Created Date:  2014-05-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0027440     Medline TA:  Srp Arh Celok Lek     Country:  Serbia    
Other Details:
Languages:  eng     Pagination:  226-8     Citation Subset:  IM    
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