TRANSCATHETER CLOSURE OF A RESIDUAL POSTMYOCARDIAL INFARCTION VENTRICULAR SEPTAL-DEFECT WITH THE AMPLATZER SEPTAL OCCLUDER

Acute ventricular septal rupture following myocardial infarction carri es a high mortality. Early surgery improves survival but long term out come depends on residual shunting and left ventricular function. Resid ual shunting is common despite apparently successful closure and may r equire reoperation. Transcatheter closure is an established method of treating selected congenital defects but clinical experience of transc atheter closure in postinfarction ventricular septal rupture is minima l. Transcatheter closure of a residual ventricular septal defect was s uccessfully done using a new device, the Amplatzer septal occluder, in a 50 year old Indian man who had previously undergone emergency surgi cal repair for postinfarction acute ventricular septal rupture. The te chnique is described and its potential as a treatment in postinfarctio n ventricular septal rupture, its possible complications, and the impo rtant aspects of case selection and device design are discussed.