MANAGEMENT OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION COMPLICATED BY VENTRICULAR SEPTAL RUPTURE - AFIC STUDY

Abstract

Objective: The aim of this study was to report management; peri-procedural and short term results of patients
hospitalized with acute myocardial infarction (MI)complicated by ventricular septal rupture (VSR) considered
high risk or unfit for surgical repair at AFIC-NIHD.
Study Design: Quasi experimental study
Place and Duration of Study: Adult and paediatric cardiology departments of Armed Forces Institute of
Cardiology / National Institute of Heart Diseases (AFIC/NIHD) from 1st January 2012 to 31st August 2013.
Patients and Methods: We included 12 patients with post myocardial infarction VSR with mean age of 59 years
(41-85 years), who underwent elective transcatheter closure. The entry criteria for trans-catheter closure after
initial medical stabilization was 1) patients with ventricular septal rupture up to 20 mm size with significant left
to right shunting (Qp/Qs >1.5) 2) defect anatomy and location thought to be suitable for device closure or
otherwise considered high risk or unfit for surgical closure.
Results: The time from the onset of infarction to the index procedure ranged between 4 to 20 days (mean 10.83
days). There were ten patients in acute phase (2 weeks or less) and two presented in sub-acute phase (> 2 weeks).
Ten patients were in NYHA class III and one each in class II and IV. A successful device implantation occurred in
all patients except in one in whom second attempt failed. The defect size ranged ........




Conclusion: Primary trans-catheter closure of post-infarction ventricular septal rupture may be an alternative to
surgery in patients............