1/27. Catheter-based fixation of the mitral valve after acute papillary muscle rupture: a new technique for temporary hemodynamic stabilization.We describe a new, catheter-based method for temporary management of hemodynamic instability after papillary muscle rupture in a patient with an acute myocardial infarction.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
2/27. Posterior myocardial infarction complicated by rupture of the posteromedial papillary muscle.A 61-year-old man was admitted with acute posterior myocardial infarction and, on physical examination, was shown to have a mitral regurgitation (MR) murmur. Transthoracic echocardiography (TTE) showed severe hypokinesis of the posterior wall and severe MR by color flow. Right heart catheterization with a balloon-tipped catheter revealed a pulmonary artery wedge pressure of 30 mmHg. No 'step-up' was seen in blood samples from the right atrium and right ventricle. On angiography, a subtotal occlusion of the mid circumflex artery was found which was angioplastied and stented. As the patient's clinical condition did not improve, he underwent transesophageal echocardiography (TEE) for further evaluation. This showed complete rupture of the posteromedial papillary muscle. The patient underwent urgent surgery with successful mitral valve replacement. The postoperative course was uncomplicated, and clinical improvement seen. This case report underscores the value of TEE in accurate preoperative diagnosis of papillary muscle rupture by providing preoperative anatomic details of the mitral valve apparatus and surrounding structures.- - - - - - - - - - ranking = 2keywords = catheter (Clic here for more details about this article) |
3/27. Acute rupture of a left ventricular false aneurysm.Left ventricular aneurysm develop when rupture of the free ventricular wall is contained by the inflammatory surrounding tissues. These false aneurysms rupture secondarily and should be treated soon after diagnosis. The diagnosis is suggested by echocardiography and confirmed by cardiac catheterization. Immediate surgery is recommended, with good survival in most reports. The patient presented in this report had ruptured his left ventricular false aneurysm before diagnosis. He was operated and had a good initial postoperative course. He died later from a severe pulmonary infection.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
4/27. ventricular septal rupture caused by myocardial bridging.A 70-year-old woman was referred to us with postinfarction angina. During cardiac catheterization the only coronary abnormality found was myocardial bridging in the mid and distal parts of the left anterior descending coronary artery, despite a large ventricular septal rupture. The pulmonary-to-systemic flow ratio was 2.5:1. Her operation was successful.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
5/27. review of ventricular rupture: key concepts and diagnostic tools for success.Although a rare complication of acute myocardial infarction (AMI), ventricular rupture is a serious event associated with significant mortality and morbidity. patients normally present with hemodynamic instability, often in cardiogenic shock. Despite improvements in surgical techniques and diagnostic tools, post-myocardial infarction ventricular rupture remains a difficult therapeutic challenge. There are three categories of ventricular rupture: free wall rupture (FWR), ventricular septal rupture (VSR), and papillary muscle rupture (PWR). The incidence of FWR occurs following up to 10% of myocardial infarctions. VSR and PWR have a lower incidence of 1-2% and 0.5-5%, respectively. patients often present with single-vessel coronary artery disease and usually do not have a positive history for a previous myocardial infarction. The incidence of post infarction angina in these patients is significantly greater than in patients without ventricular rupture. Delay in treatment and continued physical activity post infarction increases the risk of ventricular rupture. Diagnostic tools such as two-dimensional echocardiography and cardiac catheterization confirm the diagnosis of ventricular rupture in only 45-88% of cases. knowledge of the disease progression is necessary to insure accurate and timely diagnosis. Due to the rapid deterioration of these patients, there is a 50-80% mortality rate within the first week if untreated. With surgical correction, patients can extend their 5-year survival rates to 65%. A good example of the complex course of ventricular rupture is the case of a 71-year-old patient at our institution. The patient presented in cardiogenic shock following an AMI. Preoperative diagnosis was unsuccessful in determining the extent of the ventricular rupture. The correct diagnosis was determined in the operating room, and both a mitral valve replacement and closure of a ventricular septal defect were completed. The patient was successfully treated with this difficult pathology.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
6/27. Postinfarction ventricular septal defect in a patient without coronary lesions.A 46-year-old man with polycystic kidney disease was referred to our institution for ventricular septal defect complicating myocardial infarction. cardiac catheterization disclosed normal coronary arteries and absence of myocardial bridging. None of the more frequent causes of thrombosis were present, and histopathology proved negative for acute myocarditis. The surgical procedure was successful and the 11-month follow-up uneventful.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
7/27. Compassionate use of the amplatzer ASD closure device for residual postinfarction ventricular septal rupture following surgical repair.We report successful transcatheter closure of a post-MI ventricular septal rupture acutely following unsuccessful surgical repair. Catheter closure was accomplished by the use of a 26-mm Amplatzer atrial septal occluder. Initial attempts to close the defect with the use of 28-mm and 33-mm CARDIOSEAL were unsuccessful. Closure technique, immediate and long-term follow-up outcomes are reported.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
8/27. Left ventricular free-wall rupture occurring during programmed ventricular stimulation in a patient with recent myocardial infarction.In this report we describe a patient who died during programmed ventricular stimulation due to a rupture of the left ventricular free wall at the site of a recent myocardial infarction. The patient was a 75-year-old male who presented with an extensive anterior wall myocardial infarction complicated by sustained ventricular tachycardia occurring 8 days after admission. cardiac catheterization revealed total occlusion of left anterior descending coronary artery and an anteroapical aneurysm. The patient died due to electromechanical dissociation during electrophysiological testing 11 days after myocardial infarction. Postmortem examination showed a rupture of the left ventricular free wall at the site of the myocardial infarction and distant from the site of catheter placement. It is suggested that caution be taken in choosing patients for electrophysiological studies who have had recent large myocardial infarctions with ventricular aneurysm.- - - - - - - - - - ranking = 2keywords = catheter (Clic here for more details about this article) |
9/27. Transcatheter closure of a ruptured ventricular septum following inferior myocardial infarction and cardiogenic shock.Elective transcatheter closure of congenital septal defects has emerged as a valuable method, but the clinical experience on occlusion of ventricular septal rupture after myocardial infarction is very limited. We report a case of fatal outcome in a patient with inferior myocardial infarction and cardiogenic shock despite technically successful transcatheter closure of a large complex ventricular septal defect.- - - - - - - - - - ranking = 6keywords = catheter (Clic here for more details about this article) |
10/27. Successful surgical treatment of mitral regurgitation for complete rupture of the anterior papillary muscle after acute myocardial infarction.Papillary muscle rupture complicating acute myocardial infarction leads to mitral regurgitation and is associated with significant mortality. We experienced a case involving massive mitral regurgitation caused by complete anterior papillary muscle rupture following acute lateral myocardial infarction. A 75-year-old woman developed heart failure shortly after her admission, and the diagnosis was confirmed by echocardiography and cardiac catheterization. Under intra-aortic balloon pumping, the patient underwent emergency mitral valve replacement and coronary revascularization. Her postoperative course was uneventful, and she was discharged on the 40th postoperative day. We believe that prompt surgical treatment should be performed even in stable patients with ischemic mitral regurgitation, given that deterioration may be sudden and unpredictable especially in cases involving complete papillary muscle rupture.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
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