Challenges in treatment of postinfarction XXXX and @entity712 .

@entity1 @entity712 @entity9009 @entity66 @entity1757 @entity439 @entity583
INTRODUCTION: Acquired @entity1757 ( @entity1757 ) is uncommon, but serious mechanical complication of acute @entity583 with poor outcome and high mortality rate in surgically or medically treated @entity1 . CASE REPORT: We report a 58-year-old male @entity1 admitted to our hospital six days following acute @entity583 complicated by @entity9009 with signs of @entity712 . Coronary angiography revealed @entity66 , with proximally occluded dominant right coronary artery. Transthoracic echo exam revealed @entity439 of a very thin inferior septum and the basal portion of the inferior left ventricular wall, with septal wall rupture. One of the @entity1757 dimensions was 15 mm and left- to right shunt was calculated 2:1. Since the @entity1 was at too high risk for surgical closure, transcatheter closure of @entity1757 was chosen as a better option. Under short intravenous sedation, 24 mm Am- platzer device was implanted percutaneously with transesophageal echo guidance. The post-procedural result revealed a small residual shunt, but it was followed by significant improvement of the @entity1 's clinical status. A 24h Holter ECG monitoring did not show cardiac rhythm or conduction disturbances. Coronary angiography was repeated ten days following the procedure, after hemodynamic stabilization of the @entity1 , with direct stenting of the circumflex artery and the intermediate artery. Ostial left descending artery lesion was left for further functional significance assessment. CONCLUSION: Percutaneous closure with a septal occluder device can be definitive primary treatment for anatomically suitable @entity1 or it can serve as a bridge to surgical treatment.
