Abstract
The combination of an acute ventricular septal defect (VSD) and left ventricular aneurysm (LVA) is a rare, life-threatening complication which usually occurs within the first week following acute myocardial infarct- tion (AMI). We describe the case of an apical VSD and LVA in a 77-year-old diabetic and dyslipidemic male patient after anterior AMI. The patient was an active smoker and had a history of chronic obstructive pulmonary disease, arterial hypertension and atrial fibrillation. The patient underwent ventriculotomy for VSD repair using a large equine pericardial patch followed by intraventricular patch remodelling of the LVA. He was discharged 2 months after surgery and underwent a successful hip replacement 10 months later.
Highlights
Acute ventricular septal defects (VSDs) usually occur within the first week of acute myocardial infarction (AMI) [1]
The combination of an acute ventricular septal defect (VSD) and left ventricular aneurysm (LVA) is a rare, life-threatening complication which usually occurs within the first week following acute myocardial infarcttion (AMI)
We describe the case of an apical VSD and LVA in a 77-year-old diabetic and dyslipidemic male patient after anterior AMI
Summary
Acute ventricular septal defects (VSDs) usually occur within the first week of acute myocardial infarction (AMI) [1]. These defects have an incidence of 1% - 3% [2] and are associated with high mortality if not diagnosed early and adequately managed [3]. Left ventricular aneurysms (LVAs) are more common, with a reported incidence of 3.5% - 5% [4]. The true incidence of LVAs is unknown because there is no well-established definition of LVA and because of time-dependant left ventricular remodelling with late LVA occurrence [5]. LVAs have been associated with myocardial free wall rupture, congestive heart failure, left ventricular thrombus formation and ventricular tachyarrhythmias [3]. Acute VSD combined with LVA is uncommon and usually occurs within the first week of AMI
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