Abstract
Rupture of the ventricular septum is an uncommon but life-threatening complication of acute myocardial infarction (AMI). It occurs in <1% of infarcts. The noninvasive evaluation of such defects by 2-dimensional echocardiography has been reported. 1 These defects, however, can be difficult to image, particularly after anterior AMI, 2,3 when they are usually located in the apical region. Doppler color flow mapping allows visualization of the shunt flow abnormality and may thus aid in the preoperative assessment of such defects. Color flow mapping has been used intraoperatively to evaluate valve repair 4 and closure of congenital shunt lesions. 5 It may also be a useful tool in assessing the adequacy of repair of ventricular septal rupture after AMI, which continues to carry a high mortality rate despite refinement of surgical technique. We report the use of Doppler color flow mapping for the bedside assessment of ventricular septal defects complicating AMI, and its intraoperative application to assess the effectiveness of surgical repair.
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