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Complex ventricular septal rupture. The pivotal role of transesophageal echocardiography as support to surgery.

Authors
  • Almeida, Jorge
  • Gavina, Cristina
  • Torres, Pinheiro
  • Pinho, Paulo
Type
Published Article
Journal
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
Publication Date
Jan 01, 2009
Volume
28
Issue
1
Pages
105–110
Identifiers
PMID: 19388498
Source
Medline
License
Unknown

Abstract

The authors report the case of a 73-year-old male with an inferior myocardial infarction and right ventricular dysfunction, evolving in Killip class IV. On the third day in the ICU cardiogenic shock ensued and septal rupture was diagnosed. Despite the severity of the setting and the poor prognosis, it was decided to operate. Intraoperative transesophageal echocardiography (TEE) disclosed a complex inferior septal rupture that was successfully repaired with a patch by the infarct exclusion method. Postoperatively, there was recurrence of the shunt with hemodynamic instability and a redo operation was programmed. Intraoperative TEE showed a partial tear of the anterior aspect of the patch and the suture was restored. The patient was discharged 45 days following admission, after transthoracic echocardiography (TTE) showed the integrity of the patch suture and full recovery of right ventricular function.

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