3D transesophageal echocardiography is a decision-making tool for the management of cardiogenic shock following a large postinfarction ventricular defect

Journal of Cardiothoracic Surgery

Olivier Huttin²  Jean-pierre Villemot¹  Christine Selton-Suty²  Bruno Levy³  Pablo Maureira¹  Zied Frikha²  Yihua Liu¹ 

[1] Department of cardiovascular surgery and heart transplantation, 1, Allée du Morvan, Vandoeuvre-lès-Nancy, F-54500, France;Department of cardiology, CHU-Nancy F-54000, France;Department of critical care medicine, CHU-Nancy F-54000, France

关键词: Extracorporeal membrane oxygenation;    Percutaneous closure;    3-Dimensional transesophageal echocardiography;    Postinfarction ventricular septal defect;   

Others  :  1136015
DOI  :  10.1186/s13019-015-0208-y

 received in 2014-09-21, accepted in 2015-01-07,  发布年份 2015

【 摘 要 】

Postinfarction ventricular septal defect (PIVSD) is a devastating mechanical complication following acute myocardial infarction. The management of this pathology is quite challenging, especially in case of complicated cardiogenic shock. The difficulties lie in the timing and type of intervention. Debates exist with regard to immediate versus deferring repair, as well as open repair versus percutaneous closure. The anatomic characteristics and hemodynamic consequence of PIVSD are important elements determining which strategy to adopt, since large septal defect (>15 mm) cannot be appropriately treated by percutaneous occluder devices limiting by their available size, while compromised hemodynamics usually require emergent repair or mechanical support “bridging to surgery”. Herein, we report our experience of successful management of a case of cardiogenic shock complicating large PIVSD (38 mm) by delayed surgical repair bridged with Extracorporeal Membrane Oxygenation (ECMO) during 7 days. We emphasize the importance of 3-dimensional transesophageal echocardiography as a decision-making tool.

【 授权许可】

   
2015 Liu et al.; licensee BioMed Central.

【 图 表 】

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