Percutaneous treatment of a ventricular septal defect caused by MINOCA
We present a case of a 78-year-old female with a history of hypertension, paroxysmal atrial fi brillation and ischemic stroke which was admitted due to an hour-long chest pain with ECG changes indicating sinus rhythm and a newly formed LBBB. Subsequently a ventricular septal defect (VSD) was discove...
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2020-12-01
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doaj-bb7fb238ca39422fa7dbc9bbbaed0d742021-05-21T15:20:11ZbulPensoft PublishersБългарска кардиология2683-10152020-12-01264616710.3897/bgcardio.26.e5393253932Percutaneous treatment of a ventricular septal defect caused by MINOCAGeorge Dimitrov0Martina Samardzhieva1Zoran Stankov2Y. Getsov3Iana Simova4Naidenka Zlatareva5Gloria Adam6Ivo Petrov7Acibadem City Clinic - Cardiovascular CenterAcibadem City Clinic - Cardiovascular CenterAcibadem City Clinic - Cardiovascular CenterUMHAT Acibadem City ClinicAcibadem City Clinic - Cardiovascular CenterAcibadem City Clinic - Cardiovascular CenterUMHAT Acibadem City ClinicSofia UniversityWe present a case of a 78-year-old female with a history of hypertension, paroxysmal atrial fi brillation and ischemic stroke which was admitted due to an hour-long chest pain with ECG changes indicating sinus rhythm and a newly formed LBBB. Subsequently a ventricular septal defect (VSD) was discovered which we successfully treated percutaneously. At admission, echocardiography revealed septo-apical hypokinesis with an accompanying reduced left ventricular ejection fraction of 38%, in addition to the mid-ventricular septal defect (7/14 mm in size) causing a signifi cant left to right shunt (QP/QS = 1.8/1.0). Coronary angiography demonstrated lack of obstruction of the coronary vessels – MINOCA. Rapid response and Intensive care treatment, including Intra-Aortic Balloon Catheter insertion, lead to LV-functional improvement and hemodynamic stabilization. A dual access approach through the right jugular vein and right radial artery was used and eventual closure of the VSD was achieved with an Occlutech ASD occluder (20.5/16.5 mm), inserted via the venous introducer, while under constant angiographic and transesophageal echo guidance. Immediate VSD shunt elimination was disclosed by EchoCG and angiography. Overall, an uneventful in-hospital stay and six months event-free follow-up period were registered including further EchoCG which confi rmed lack of major cardio-vascular events and the stable position of the occluder, without a visible shunt.https://journal.bgcardio.org/article/53932/download/pdf/MINOCAVSDMIpercutaneous treatment of VSD pos |
collection |
DOAJ |
language |
Bulgarian |
format |
Article |
sources |
DOAJ |
author |
George Dimitrov Martina Samardzhieva Zoran Stankov Y. Getsov Iana Simova Naidenka Zlatareva Gloria Adam Ivo Petrov |
spellingShingle |
George Dimitrov Martina Samardzhieva Zoran Stankov Y. Getsov Iana Simova Naidenka Zlatareva Gloria Adam Ivo Petrov Percutaneous treatment of a ventricular septal defect caused by MINOCA Българска кардиология MINOCA VSD MI percutaneous treatment of VSD pos |
author_facet |
George Dimitrov Martina Samardzhieva Zoran Stankov Y. Getsov Iana Simova Naidenka Zlatareva Gloria Adam Ivo Petrov |
author_sort |
George Dimitrov |
title |
Percutaneous treatment of a ventricular septal defect caused by MINOCA |
title_short |
Percutaneous treatment of a ventricular septal defect caused by MINOCA |
title_full |
Percutaneous treatment of a ventricular septal defect caused by MINOCA |
title_fullStr |
Percutaneous treatment of a ventricular septal defect caused by MINOCA |
title_full_unstemmed |
Percutaneous treatment of a ventricular septal defect caused by MINOCA |
title_sort |
percutaneous treatment of a ventricular septal defect caused by minoca |
publisher |
Pensoft Publishers |
series |
Българска кардиология |
issn |
2683-1015 |
publishDate |
2020-12-01 |
description |
We present a case of a 78-year-old female with a history of hypertension, paroxysmal atrial fi brillation and ischemic stroke which was admitted due to an hour-long chest pain with ECG changes indicating sinus rhythm and a newly formed LBBB. Subsequently a ventricular septal defect (VSD) was discovered which we successfully treated percutaneously. At admission, echocardiography revealed septo-apical hypokinesis with an accompanying reduced left ventricular ejection fraction of 38%, in addition to the mid-ventricular septal defect (7/14 mm in size) causing a signifi cant left to right shunt (QP/QS = 1.8/1.0). Coronary angiography demonstrated lack of obstruction of the coronary vessels – MINOCA. Rapid response and Intensive care treatment, including Intra-Aortic Balloon Catheter insertion, lead to LV-functional improvement and hemodynamic stabilization. A dual access approach through the right jugular vein and right radial artery was used and eventual closure of the VSD was achieved with an Occlutech ASD occluder (20.5/16.5 mm), inserted via the venous introducer, while under constant angiographic and transesophageal echo guidance. Immediate VSD shunt elimination was disclosed by EchoCG and angiography. Overall, an uneventful in-hospital stay and six months event-free follow-up period were registered including further EchoCG which confi rmed lack of major cardio-vascular events and the stable position of the occluder, without a visible shunt. |
topic |
MINOCA VSD MI percutaneous treatment of VSD pos |
url |
https://journal.bgcardio.org/article/53932/download/pdf/ |
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