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Real-Time 3D Interventional Echocardiography pp 137–149Cite as

Closure of Post-AMI Ventricular Septal Defect

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Abstract

Ventricular septal defect (VSD) is a rare but deadly mechanical complication of acute myocardial infarction (AMI). Although significantly lower than with conservative management, in-hospital mortality after surgery remains as high as 47%, and dehiscence of the patch requiring a second operation is not infrequent because the sutures may teat out of the friable support around the defect. In today's era of percutaneous interventions, percutaneous closure is considered a valid alternative to surgical repair in patients with small to medium VSDs, since the occlusion device may provide a definitive treatment. Two-dimensional TTE/TEE color Doppler provides the most rapid diagnosis by demonstration of a discontinuity in the ventricular septum with left-to-right shunt. 3D TEE appears to be a very valuable tool in showing the defect as it anatomically is: a hole through the septum. In this chapter we describe 3D TEE anatomy of ventricular septum, 3D TEE imaging of post-AMI VSDs, and the current use of 3D TEE during percutaneous closure with catheter-based devices.

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Author information

Authors and Affiliations

  1. Department of Cardiology, Cardiocentro Ticino, Lugano, Switzerland

    Francesco Fulvio Faletra

  2. Non-Invasive Cardiology, Lenox Hill Hospital, New York, NY, USA

    Gila Perk & Itzhak Kronzon

  3. Tufts University School of Medicine, Boston, MA, USA

    Natesa G. Pandian

  4. Department of Medicine Elisabethinen, Teaching Hospital, Linz, Austria

    Hans-Joachim Nesser

Authors
  1. Francesco Fulvio Faletra
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  2. Gila Perk
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  3. Natesa G. Pandian
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  4. Hans-Joachim Nesser
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  5. Itzhak Kronzon
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7.1 Electronic Supplementary material

Below is the link to the electronic supplementary material.

309054_1_En_7_MOESM1_ESM.avi

Apical post-AMI defect from the left perspective (AVI 1020 kb)

309054_1_En_7_MOESM2_ESM.avi

Apical post-AMI defect from the right perspective (AVI 1016 kb)

Large post-AMI VSD at the base of the heart, below mitral valve (AVI 7016 kb)

309054_1_En_7_MOESM4_ESM.avi

View of the interventricular septum with both discs of the device correctly deployed (AVI 1437 kb)

309054_1_En_7_MOESM5_ESM.avi

“En face” perspective visualizing the device from the left perspective (AVI 1442 kb)

309054_1_En_7_MOESM6_ESM.avi

“En face” perspective visualizing the device from the right perspective (AVI 1481 kb)

Video 7.1

Apical post-AMI defect from the left perspective (AVI 1020 kb)

Video 7.2

Apical post-AMI defect from the right perspective (AVI 1016 kb)

Video 7.4

View of the interventricular septum with both discs of the device correctly deployed (AVI 1437 kb)

Video 7.5

“En face” perspective visualizing the device from the left perspective (AVI 1442 kb)

Video 7.6

“En face” perspective visualizing the device from the right perspective (AVI 1481 kb)

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© 2014 Springer-Verlag London

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Faletra, F.F., Perk, G., Pandian, N.G., Nesser, HJ., Kronzon, I. (2014). Closure of Post-AMI Ventricular Septal Defect. In: Real-Time 3D Interventional Echocardiography. Springer, London. https://doi.org/10.1007/978-1-4471-4745-9_7

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  • DOI: https://doi.org/10.1007/978-1-4471-4745-9_7

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4744-2

  • Online ISBN: 978-1-4471-4745-9

  • eBook Packages: MedicineMedicine (R0)

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