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Case Reports
. 2022 Jul 31:2022:5690844.
doi: 10.1155/2022/5690844. eCollection 2022.

Post-Myocardial Infarction Ventricular Septal Defect Successfully Treated with Impella as Bridge to Cardiac Transplantation

Lauren Giudicatti  1 , Benjamin Silbert  2 , Xiao-Fang Xu  1 , Anthony Putrino  1 , Felicity Lee  2 , Amit Shah  2 , Robert Larbalestier  3 , Karim Slimani  3 , Andrew Laycock  4 , Kaitlyn Lam  2
Affiliations
Case Reports

Post-Myocardial Infarction Ventricular Septal Defect Successfully Treated with Impella as Bridge to Cardiac Transplantation

Lauren Giudicatti et al. Case Rep Cardiol. .

Abstract

A 63-year-old female presented late with anterior ST-elevation myocardial infarction and cardiogenic shock. This was complicated by acute ventricular septal defect with large left-to-right shunt. An Impella CP was inserted on day seven with rapid haemodynamic improvement. This facilitated bridge to cardiac transplant on day twelve post-MI.

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Conflict of interest statement

The authors have no disclosures to declare.

Figures

Figure 1
Figure 1
Transthoracic echocardiogram, parasternal long axis view, demonstrating a 1.3 cm muscular VSD in the basal anteroseptum ((a), arrow) with left-to-right shunting on colour Doppler (b).
Figure 2
Figure 2
Transesophageal echocardiogram, midesophageal 3-chamber view taken whilst on Impella support, showing large VSD with left-to-right shunting on colour Doppler.
Figure 3
Figure 3
Explanted heart showing. (a) Cross-section through the basal (left) to apical (right) left ventricle (LV) demonstrating haemorrhagic infarct involving the interventricular septum (IVS) and anterior LV (asterisk). A defect is evident through the infarcted region of the IVS (arrow). (b) At low power, a full thickness defect is evident through the region of infarction (arrow), allowing communication from LV to RV, via a tortuous path.
See this image and copyright information in PMC

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