Techniques, Timing, and Prognosis of Transcatheter Post Myocardial Infarction Ventricular Septal Defect Repair

Curr Cardiol Rep. 2019 May 20;21(7):59. doi: 10.1007/s11886-019-1142-8.

Abstract

Purpose of review: This review aims to delineate the actual role of percutaneous intervention in the closure of post-myocardial infarction ventricular septal defect (post-MI VSD) and to briefly summarize the main steps of this procedure.

Recent findings: Most of the published studies report experiences using Amplatzer devices for post-MI VSD closure. In the acute phase, morbidity and mortality are quite high up to 70%, with a mean success rate of 90%, with 95% confidence intervals from 60 to 100%, and a 30-day mortality of 40%, with 95% confidence intervals from 0 to 55%. In the chronic phase, that is 14 days after myocardial infarction, results are very encouraging, with lower morbidity and mortality (23% at 30 days) and a higher rate of complete closure. A multimodality imaging approach has been proposed in order to increase the success rate of this procedure. Percutaneous closure is a safe and effective procedure in highly specialized centers and an appropriate patient selection is of paramount importance to the success of the procedure. Device closure of post-MI VSD can be considered a true alternative to the standard surgical approach. However, many problems still exist for percutaneous post-MI VSD treatment.

Keywords: Percutaneous intervention; Post-myocardial infarction ventricular septal defect; Ventricular septal defect occluder.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / methods*
  • Heart Septal Defects, Ventricular / diagnosis
  • Heart Septal Defects, Ventricular / etiology
  • Heart Septal Defects, Ventricular / surgery*
  • Humans
  • Myocardial Infarction / complications*
  • Myocardial Infarction / surgery
  • Postoperative Complications
  • Prognosis
  • Septal Occluder Device*
  • Time Factors
  • Treatment Outcome