Acute Myocardial Infarction - Ventricular Septal Defect

Author: Aneet Patel, MD; Edward Verrier, MD
Institution: University of Washington
Date Reviewed: March 2014
Learning Domain: Adult Cardiac Surgery
Learning Objective: Management  Strategies for Complications of Acute Myocardial Infarction
PowerPoint File: Acute Myocardial Infarction - Ventricular Septal Defect

 

Discussion Points for Conference

  • Natural history  / Timing of post infarction complication
  • Presentation 
  • Initial Management Priorities
  • Potential therapeutic Approaches
  • Surgical Approaches
    • Technical considerations
  • Expected outcomes
  • Complications 

 

Learning Points

  • Post Myocardial Infarctions complications rare
  • Acute VSD has high mortality (~50%)
  • Acute medical management must be optimized first
  • Surgery probably better than Medical management in selected cases (>90%)
  • Role of Interventional  (VSD occluders) approaches unclear
  • Infarct / VSD exclusion (David) approach probably preferred surgical approach