Primary transcatheter closure of post-myocardial infarction ventricular septal rupture using amplatzer atrial septal occlusion device: A study from tertiary care in South India.
OBJECTIVE
The study investigated effectiveness of transcatheter closure of post-myocardial infarction (MI) ventricular septal rupture (VSR) using atrial septal device (ASD) occluder in a cohort of patients admitted at our institute.


METHOD
This was a retrospective, observational and single center study, which included patients who were treated with transcatheter closure for post-MI VSR at our tertiary care center between May 2000 and August 2014 depending upon inclusion and exclusion criteria. Primary outcome was all-cause mortality at 30-days follow-up. The MELD-XI (Model for End Stage Liver Disease) score was used as a predictor for poor outcome in these patients.


RESULTS
A total of 21 patients (mean age 66.4±5.9years) were included in the study. Study cohort predominantly included male patients (n=15; 71.4%) and patients with single vessel disease (n=15; 71.4%). Revascularization of the culprit lesion, before VSR closure, was attempted in 6 patients. Except one patient (treated with Cera® occluder), all patients were treated with Amplatzer® ASD occluders. Average diameter of VSR was 20.8±6.9mm. Diameter of the device used in the study ranged from 10mm to 30mm. Residual defect was detected in 13 patients (62%). All-cause mortality at 30-day follow-up was observed in 9 (42.9%) patients. Time to VSR closure, diameter of VSR, and serum creatinine levels were significantly related to the 30-day mortality. MELD-XI score was found to be strongly associated with increased risk of mortality.


CONCLUSION
Primary transcatheter VSR closure using ASD occluders is a feasible approach which can provide reasonable survival outcomes along with equitable mortality rates.
['Aggarwal|Manav|M|', 'Natarajan|Kumaraswamy|K|', 'Vijayakumar|Maniyal|M|', 'Chandrasekhar|Rajiv|R|', 'Mathew|Navin|N|', 'Vijan|Vikrant|V|', 'Vupputuri|Anjith|A|', 'Chintamani|Sanjeev|S|', 'Rajendran|Bishnu Kiran|BK|', 'Thachathodiyl|Rajesh|R|']
D000368:Aged D006328:Cardiac Catheterization D006348:Cardiac Surgical Procedures D017023:Coronary Angiography D005260:Female D005500:Follow-Up Studies D006801:Humans D015994:Incidence D007194:India D008297:Male D012189:Retrospective Studies D055989:Septal Occluder Device D015996:Survival Rate D062606:Tertiary Care Centers D018658:Ventricular Septal Rupture
Ventricular septal rupture (VSR) Double umbrella Post myocardial infarction Septal occluder Ventricular septal defect