Improved outcomes in the treatment of post-myocardial infarction ventricular septal defect with percutaneous TandemHeart left ventricular mechanical circulatory support

Authors

Pranav Loyalka, University of Texas Health Science Center at HoustonFollow
Angelo Nascimbene, University of Texas Health Science Center at HoustonFollow
Sriram S. Nathan, University of Texas Health Science Center at HoustonFollow
Rajko Radovancevic, University of Texas Health Science Center at HoustonFollow
Ajay S. Raman, University of Texas Health Science Center at HoustonFollow
Manish K. Patel, The University of Texas Health Science Center at HoustonFollow
Keshava Rajagopal, University of Texas Health Science Center at HoustonFollow
Biswajit Kar, University of Texas Health Science Center at HoustonFollow
Igor D. Gregoric, University of Texas Health Science Center at HoustonFollow

Document Type

Original Research

Abstract

Background

Post-myocardial infarction (MI) ventricular septal defect (VSD) is associated with 40% - 50% of peri-procedural mortalities; however, it is amenable to catheter-based therapies. We retrospectively investigated the impact of state-of-the-art bridging percutaneous left ventricular mechanical circulatory support (MCS) using the TandemHeart® (TH) ventricular assist device (VAD) on a patient with post-MI VSD.

Results

From July 2008 to March 2014, 23 patients were referred for treatment of post-MI VSD. Initially, 18/23 patients required MCS; 12 received an intra-aortic balloon pump (IABP), while 6 received initial TH support. Seven of the IABP patients later required TH support. Catheter-based device VSD closure was performed in 18 of the patients; however, three patients required conversion to conventional open cardiac surgical repair via VSD patch closure due to failure of the catheter-based approach. Five patients with TH underwent planned open cardiac surgical repair due to an anticipated lack of suitability for catheter-based treatment. Results revealed that delayed closure after MI correlated with improved survival. Overall, 30-day and 6-month survival rates were 83% (19/23) and 70% (16/23), respectively.

Conclusions

Further, Qp/Qs ratios of

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Recommended Citation

Loyalka, Pranav; Nascimbene, Angelo; Nathan, Sriram S.; Radovancevic, Rajko; Raman, Ajay S.; Patel, Manish K.; Rajagopal, Keshava; Kar, Biswajit; and Gregoric, Igor D. (2020) "Improved outcomes in the treatment of post-myocardial infarction ventricular septal defect with percutaneous TandemHeart left ventricular mechanical circulatory support," The VAD Journal: Vol. 6(1) :e20206110 DOI: https://doi.org/10.11589/vad/e20206110

Available at: https://digitalcommons.library.tmc.edu/vad/vol6/iss1/10

First Page

e20206110