RT Book, Section
A1 Agnihotri, Arvind K.
A1 Madsen, Joren C.
A1 Daggett, Jr., Willard M.
A2 Cohn, Lawrence H.
SR Print(0)
ID 55918915
T1 Chapter 28. Surgical Treatment of Complications of Acute Myocardial Infarction: Postinfarction Ventricular Septal Defect and Free Wall Rupture
T2 Cardiac Surgery in the Adult, 4e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-163310-9
LK accesssurgery.mhmedical.com/content.aspx?aid=55918915
RD 2024/04/24
AB Rupture  of  the  ventricular  chamber  (septum  or  free  wall)  after  myocardial  infarction  is  a  relatively  infrequent  condition  with  high  mortality.  An  acute  postinfarction  VSD  is  a  perforation  of  the  muscular  ventricular  septum  occurring  in  an  area  of  acutely  infarcted  myocardium.  A  ventricular  septal  rupture  may  be  termed  chronic  when  it  has  been  present  for  more  than  4  to  6  weeks.  A  postinfarction  ventricular  rupture  is  a  perforation  of  the  ventricular  free  wall  occurring  in  an  area  of  acutely  infarcted  myocardium.  These  conditions,  resulting  from  transmural  infarction,  may  cause  rapid  hemodynamic  compromise  and  early  death  precluding  surgical  repair.  Free  wall  rupture  can  result  in  tamponade  and  sudden  cardiovascular  collapse.  In  ventricular  septal  rupture,  there  is  a  variable  amount  of  left-to-right  shunting,  but  such  defects  typically  lead  to  symptoms  of  heart  failure.  The  clinical  presentation  ranges  from  an  asymptomatic  murmur  to  cardiogenic  shock  and  sudden  death.