Transcatheter closure of a complex postmyocardial infarction ventricular septal defect after surgical patch dehiscence

Unplanned staged hybrid management of postmyocardial infarction ventricular septal defect

Ventricular septal defect (VSD) is an uncommon but potentially deadly complication of transmural myocardial infarction (MI). Emergency surgical treatment has traditionally offered the best chance for survival. However, operative intervention is associated with high mortality and can be complicated by a recurrent VSD due to tissue friability around the infarcted area. Percutaneous catheter-based closure techniques can be used to treat these critically ill patients, offering a less invasive and less morbid technique. This case demonstrates the successful application of an unplanned, staged hybrid approach utilizing initial percutaneous and subsequent surgical repair after recovery of tissue integrity.