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

Abstract

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. 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 14days after myocardial infarction, results are very encouraging, with lower morbidity and mortality (23% at 30days) 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.