Right ventricle free wall rupture during transcatheter occluder implantation in a patient with postinfarction rupture of the interventricular septum and COVID-19-associated myocarditis. Case report

Cover Page

Cite item

Full Text

Abstract

Intraventricular septum rupture is a rare mechanic complication of myocardial infarction associated with high mortality. This case describes STEMI in recovered patient after COVID 19 associated pneumonia, which was complicated by ventricular septum rupture followed by cardiogenic shock. It was managed by percutaneous occluder implantation. The procedure was complicated by right ventricular wall rupture. Postmortem examination of myocardium showed the signs of inflammation infiltrate and myocyte necrosis, according to histopathological Dallas criteria diagnosis of COVID-19 associated myocarditis was established. The COVID-19 pandemic has contributed to increasing cardiovascular mortality. This is typically attributed to diminishing resources for timely and appropriate medical care, and patients’ late presentations for fear of contracting the infection. Cardiovascular complication of COVID-19 may be another contributing factor. Further research is needed to improve our understanding of the mechanisms and long-term sequelae of myocardium damage in COVID-19, to optimize treatment strategy and subsequent follow-up in such patients.

About the authors

Dmitry V. Pevzner

Chazov National Medical Research Center of Cardiology

Author for correspondence.
Email: pevsner@mail.ru
ORCID iD: 0000-0002-5290-0065

канд. мед. наук, ст. науч. сотр., зав. блоком интенсивной терапии отд. неотложной кардиологии

Russian Federation, Moscow

Tatiana S. Sukhinina

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0002-5509-6623

канд. мед. наук, ст. науч. сотр. отд. неотложной кардиологии

Russian Federation, Moscow

Egor N. Anufriev

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0002-9660-9851

врач-кардиолог отд. неотложной кардиологии

Russian Federation, Moscow

Natalia S. Kostritca

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0002-8746-8727

врач-ординатор отд. неотложной кардиологии

Russian Federation, Moscow

Eric A. Avetisyan

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0002-0331-2179

врач-кардиолог отд. неотложной кардиологии

Russian Federation, Moscow

Victor N. Shitov

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0002-8878-7340

врач-кардиолог блока интенсивной терапии отд. неотложной кардиологии, врач ультразвуковой диагностики

Russian Federation, Moscow

Ella V. Kurilina

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0002-3208-534X

зав. отд-нием патанатомии

Russian Federation, Moscow

Aleksandr G. Osiev

MEDSI Group of Companies

Email: pevsner@mail.ru
ORCID iD: 0000-0001-5263-0387

д-р мед. наук, проф., зав. отд-нием рентгенхирургии

Russian Federation, Moscow

Evgeny V. Merkulov

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0001-8193-8575

д-р мед. наук, ст. науч. сотр., зав. 1-м отд-нием рентгенхирургических методов диагностики и лечения

Russian Federation, Moscow

Andrew S. Tereshchenko

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0002-4198-0522

канд. мед. наук, ст. науч. сотр. отд. рентгенэндоваскулярных методов диагностики и лечения

Russian Federation, Moscow

Sergey A. Boytsov

Chazov National Medical Research Center of Cardiology

Email: pevsner@mail.ru
ORCID iD: 0000-0001-6998-8406

акад. РАН, д-р мед. наук, проф., ген. дир

Russian Federation, Moscow

References

  1. Mubarik A, Iqbal AM. Ventricular Septal Rupture. 2022 Feb 14. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
  2. Birnbaum Y, Fishbein MC, Blanche C, Siegel RJ. Ventricular septal rupture after acute myocardial infarction. N Engl J Med. 2002;347(18):1426-32. doi: 10.1056/NEJMra020228
  3. Jones BM, Kapadia SR, Smedira NG, et al. Ventricular septal rupture complicating acute myocardial infarction: a contemporary review. Eur Heart J. 2014;35(31):2060-8. doi: 10.1093/eurheartj/ehu248
  4. Mahajan K, Shah N, Patel H. Post Infarct Ventricular Septal Rupture. 2021 Sep 28. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2022.
  5. Thiele H, Kaulfersch C, Daehnert I, et al. Immediate primary transcatheter closure of postinfarction ventricular septal defects. Eur Heart J. 2009;30(1):81-8. doi: 10.1093/eurheartj/ehn524
  6. Faccini A, Butera G. Techniques, Timing, and Prognosis of Transcatheter Post Myocardial Infarction Ventricular Septal Defect Repair. Curr Cardiol Rep. 2019;21(7):59. doi: 10.1007/s11886-019-1142-8
  7. Risseeuw F, Diebels I, Vandendriessche T, et al. Percutaneous occlusion of post-myocardial infarction ventricular septum rupture. Neth Heart J. 2014;22(2):47-51. doi: 10.1007/s12471-013-0498-4
  8. Shabestari MM, Ghaderi F, Hamedanchi A. Transcatheter Closure of Postinfarction Ventricular Septal Defect: A Case Report and Review of Literature. J Cardiovasc Thorac Res. 2015;7(2):75-7. doi: 10.15171/jcvtr.2015.17
  9. Holzer R, Balzer D, Amin Z, et al. Transcatheter closure of postinfarction ventricular septal defects using the new Amplatzer muscular VSD occluder: Results of a U.S. Registry. Catheter Cardiovasc Interv. 2004;61(2):196-201. doi: 10.1002/ccd.10784
  10. Dawson AG, Williams SG, Cole D. Does the placement of an Amplatzer septal occluder device confer benefit in patients with a post-infarction ventricular septal defect? Interact Cardiovasc Thorac Surg. 2014;19(6):1040-7. doi: 10.1093/icvts/ivu293
  11. Shahreyar M, Akinseye O, Nayyar M, et al. Post-Myocardial Infarction Ventricular Septal Defect: A Comprehensive Review. Cardiovasc Revasc Med. 2020;21(11):1444-9. doi: 10.1016/j.carrev.2018.11.017
  12. Fragkouli K, Mitselou A, Boumba V, et al. An autopsy case of necrotizing eosinophilic myocarditis causing left ventricular wall rupture. Forensic Sci Med Pathol. 2011;7(4):350-4. doi: 10.1007/s12024-011-9235-8
  13. Kondo T, Nagasaki Y, Takahashi M, et al. An autopsy case of cardiac tamponade caused by a ruptured ventricular aneurysm associated with acute myocarditis. Leg Med (Tokyo). 2016;18:44-8. doi: 10.1016/j.legalmed.2015.12.002
  14. Stock E, Lubbe T. Rupture of the right ventricle in acute myocarditis. Br Heart J. 1968;30(1):135-7. doi: 10.1136/hrt.30.1.135
  15. Siripanthong B, Nazarian S, Muser D, et al. Recognizing COVID-19-related myocarditis: The possible pathophysiology and proposed guideline for diagnosis and management. Heart Rhythm. 2020;17(9):1463-71. doi: 10.1016/j.hrthm.2020.05.001
  16. Greenberg A, Pemmasani G, Yandrapalli S, Frishman WH. Cardiovascular and Cerebrovascular Complications With COVID-19. Cardiol Rev. 2021;29(3):143-9. doi: 10.1097/CRD.0000000000000385
  17. Lee DW, Gardner R, Porter DL, et al. Current concepts in the diagnosis and management of cytokine release syndrome. Blood. 2014;124:188-95. doi: 10.1182/blood-2014-05-552729
  18. Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. J Am Coll Cardiol. 2020;75(18):2352-71. doi: 10.1016/j.jacc.2020.03.031
  19. Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17(5):259-60. doi: 10.1038/s41569-020-0360-5
  20. Rey JR, Jiménez Valero S, Poveda Pinedo D, et al. COVID-19 y trombosis simultánea en dos arterias coronarias [COVID-19 and simultaneous thrombosis of two coronary arteries]. Rev Esp Cardiol. 2020;73(8):676-8. doi: 10.1016/j.recesp.2020.05.004
  21. Bangalore S, Sharma A, Slotwiner A, et al. ST-Segment Elevation in Patients with Covid-19 – A Case Series. N Engl J Med. 2020;382(25):2478-80. doi: 10.1056/NEJMc2009020
  22. Lang JP, Wang X, Moura FA, et al. A current review of COVID-19 for the cardiovascular specialist. Am Heart J. 2020;226:29-44. doi: 10.1016/j.ahj.2020.04.025
  23. Lakhdar S, Buttar Ch, Perez L, et al. ST Elevation Myocardial Infarction in Patients with COVID-19: Case Series. EMJ. 2022;7:38-46.
  24. Kociol RD, Cooper LT, Fang JC, et al. American Heart Association Heart Failure and Transplantation Committee of the Council on Clinical Cardiology. Recognition and Initial Management of Fulminant Myocarditis: A Scientific Statement From the American Heart Association. Circulation. 2020;141(6):e6992. doi: 10.1161/CIR.0000000000000745

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Coronary angiography: before percutaneous coronary intervention.

Download (122KB)
Indexing metadata
3. Fig. 2. Coronary angiography: after percutaneous coronary intervention.

Download (123KB)
Indexing metadata
4. Fig. 3. Ventricular septal defect visualized by echocardiography in the four-chamber view.

Download (69KB)
Indexing metadata
5. Fig. 4. Ventricular septal occluder implantation.

Download (67KB)
Indexing metadata
6. Fig. 5. Pronounced myocardial stromal edema, leukocyte infiltration.

Download (175KB)
Indexing metadata

Copyright (c) 2023 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies