Successful correction of post-infarction ventricular septal defect

Authors: Ponomarenko I.V., Sukmanova I.A., Melnikova A.A., Ananyev D.A.

Company: 1 Altai Regional Cardiological Dispensary, Barnaul, Russian Federation
2 Altai State Medical University, Barnaul, Russian Federation

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Type:  Clinical Cases


DOI: https://doi.org/10.24022/1997-3187-2024-18-1-113-118

For citation: Ponomarenko I.V., Sukmanova I.A., Melnikova A.A., Ananyev D.A. Successful correction of post-infarction ventricular septal defect. Creative Cardiology. 2024; 18 (1): 113–118 (in Russ.). DOI: 10.24022/1997-3187-2024-18-1-113-118

Received / Accepted:  26.12.2023 / 16.01.2024

Keywords: acute myocardial infarction mechanical complications ventricular septal defect



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Abstract

Rupture of the interventricular septum is the most common mechanical complication of myocardial infarction, it occurs in about 0.21% in myocardial infarction with ST segment elevation and in 0.04% in myocardial infarction without ST segment elevation, with a high mortality rate. Surgical treatment is the only method that allows saving a patient's life with this formidable complication, nevertheless, surgery of a postinfarction defect of the interventricular septum is associated with certain difficulties and high operational risk. The mortality rate for correction of ventricular septal defect is 38–50%, and today it is one of the highest rates in cardiac surgery. A safer period for surgical intervention is 30 days after myocardial infarction, when connective tissue or scars form around the defect, which leads to better fixation of the suture material and a decrease in the likelihood of recanalization of the defect. But in the case of a serious patient's condition and deteriorating hemodynamic parameters, the elimination of an interventricular septal defect is a life-saving operation. A clinical case of successful correction of a postinfarction defect of the interventricular septum on the 16th day of the disease in a patient with unstable hemodynamics is presented.

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About Authors

  • Irina V. Ponomarenko, Cand. Med. Sci., Cardiologist of the Cardiology Department for Patients with Acute Coronary Syndrome of the ARCD, Assistant at the Department of Cardiology and Cardiovascular Surgery with Additional Professional Education ASMU; ORCID
  • Irina A. Sukmanova, Dr. Med. Sci., Head of the Cardiology Department for patients with acute coronary syndrome of the ARCD, Professor of the Department of Cardiology and Cardiovascular Surgery with a course of Additional Professional Education ASMU; ORCID
  • Anna A. Melnikova, Cardiologist; ORCID
  • Dmitriy A. Ananyev, Head of the Center for Cardiovascular Surgery, Cardiac Surgeon; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery