Methodist Journal

IN THIS ISSUE

Nutritional Supplements and the Heart

Vol 15, Issue 3 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

Dietary Supplements: Facts and Fallacies

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RECOGNITIONS

Drs. Raizner and Cooke Take the Lead in Special Issue on Supplements

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REVIEW ARTICLES See More

Recent Clinical Trials Shed New Light on the Cardiovascular Benefits of Omega-3 Fatty Acids

Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment

Coenzyme Q10

Red Yeast Rice for Hypercholesterolemia

Inorganic Nitrate Supplementation for Cardiovascular Health

Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk?

Cardiovascular Risk of Proton Pump Inhibitors

Advanced Cardiac Imaging for Complex Adult Congenital Heart Diseases

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Snoopy’s Heart: A Case of Complete Congenital Absence of the Pericardium

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

POINTS TO REMEMBER

The Kidney in Congenital Cyanotic Heart Disease

EXCERPTA

Talking Statins with Antonio Gotto

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 12, Issue 1 (2016)

Article Full Text

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER

Transcatheter Closure and Reintervention on an Expanding Post-Myocardial Infarction Ventricular Septal Rupture

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Article Citation:

Eric J. Bansal, Joshua L. McKay, and C. Huie Lin. Transcatheter Closure and Reintervention on an Expanding Post-Myocardial Infarction Ventricular Septal Rupture. Methodist DeBakey Cardiovascular Journal. January 2016, Vol. 12, No. 1, pp. 56-59.

doi: https://doi.org/10.14797/mdcj-12-1-56

Keywords
echocardiography , computed tomography , myocardial infarction , ventral septal rupture

A 74-year-old woman presented with an ST-elevation myocardial infarction (MI) and subsequently developed a post-MI apical ventricular septal rupture (VSR). Transesophageal echocardiogram (TEE) showed the defect to be 15 mm wide (Figure 1A). Due to hemodynamic instability, she underwent percutaneous closure of the VSR 5 days post-MI with an 18-mm AMPLATZER Muscular Ventricular Septal Defect (VSD) Occluder (St. Jude Medical, St. Paul, Minnesota) with no immediate evidence of residual shunt on TEE imaging (Figure 1B). Fourteen days after intervention, 64-slice cardiac computed tomography revealed that the inferior portion of the septum had torn away from the device due to ongoing tissue necrosis with evidence of left-to-right shunt through a recurrent VSR (Figure 2). Repeat percutaneous intervention was undertaken, and a 24-mm AMPLATZER Atrial Septal Defect Occluder (St. Jude Medical, St. Paul, Minnesota) was placed. Cine imaging (Figure 3) shows the AMPLATZER Atrial Septal Defect Occluder (labeled ASD) across the ventricular septum and adjacent to the originally placed AMPLATZER Muscular VSD Occluder (labeled mVSD). Final transthoracic echocardiography showed no significant residual shunt (Figure 4). LV: left ventricle; RV: right ventricle; ASD: AMPLATZER Atrial Septal Defect Occluder; mVSD: AMPLATZER Muscular Ventricular Septal Defect Occluder.

Figure 1. (A) Pre-procedure transesophageal color Doppler flow showing left-to-right shunting through a post-myocardial infarction ventricular septal rupture. (B) No residual shunt is seen immediately after deployment of an Amplatzer muscular ventricular septal defect occluder. LV: left ventricle; RV: right ventricle
Figure 3. Cine imaging showing successful deployment of the Amplatzer atrial septal defect occluder adjacent to the Amplatzer muscular ventricular septal defect occluder. ASD: atrial septal defect occluder; mVSD: muscular ventricular septal defect occluder
Figure 2. Residual shunting is seen by cardiac computed tomography. The Amplatzer muscular ventricular septal defect occluder is surrounded by necrotic myocardium with residual left-to-right shunting. *: necrotic myocardium; LV: left ventricle; RV: right ventricle
Figure 4. Transthoracic color Doppler flow showing both devices across the septum with no significant residual shunt. LV: left ventricle; RV: right ventricle

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