Post-myocardial infarction ventricular septal defect: coronary anatomy and cardiac hemodynamics in patients with successful surgical closure.
Dhawan, S.; Dhall, A.; Lahiri, S.; Yadav, O.P.; Khanna, O.K.; Mantri, R.R.; Passey, R.; Mehta, A. and Sharma, V. (2002) Post-myocardial infarction ventricular septal defect: coronary anatomy and cardiac hemodynamics in patients with successful surgical closure. Indian Heart Journal, 54. k237.
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Acute myocardial infarction complicated by ventricular septal defect is seen in 0.5%-l% of patients of acute myocardial infarction. We hereby present the coronary anatomy and cardiac hemodynamics in five cases presenting to our center between June 2000 and July 2002. Three patients (42.8%) had acute anterior myocardial infarction and 2 (40%) had acute inferior wall myocardial infarction. All the patients were in Killip class III—IV. Mean BP was 86+12 mmHg. Three (60%) required intra-aortic balloon pump. Ventricular septal defect was located echocardiographically in the anterior interventricular septum in 3 patients (60%) and in the posterobasal septum in 2 (40%). The size of the defect varied from 8 mm-20 mm. All were muscular in location. Associated mitral regurgitation was seen in 2 patients (40%). On cardiac catheterization, pulmonary artery systolic pressures were elevated in 4 patients (80%). All the patients underwent successful surgical closure. Three (60%) patients developed renal failure in the postoperative period. However, all patients were discharged in a stable condition from the hospital.
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