Acute Myocardial Infarction - Ventricular Septal Defect - Interventional Approach

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 - Interventional Approach

 

Discussion Points for Conference

  • Presentation / Timing / Natural History
    • Complications of Acute MI
  • Initial hemodynamic management strategies
  • Use of Intra-aortic Balloon Counterpulsation
  • Therapeutic Options ?
  • Role of Interventional Approaches
    • Bridge to Surgery
    • Definitive Therapy

 

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