Dr. Ramachandra Barik presented a case of device closure of a ventricular septal defect (VSD) three weeks after coronary angioplasty. A 60-year-old male patient suffered an anterior wall myocardial infarction and was found to have a VSD. He underwent coronary angioplasty to treat the infarction. Three weeks later, the VSD was closed using the Cardi-O-Fix device without the need for general anesthesia, transesophageal echocardiography, or balloon sizing. Initial follow up echocardiograms showed no residual shunting. Dr. Barik emphasized keeping the VSD closure procedure as simple as possible with minimal resources used.
Human: [
ICT Role in 21st Century Education & its Challenges.pptx
conference presentation of your reseach
1. Speaker’s name: Dr Ramachandra Barik,
Assistant professor
Department of cardiology
Nizam’s Institute of Medical science.
Hyderabad
INDIA.
I do not have any potential conflict of interest
2. Device Closure Of Ventricular Septal Defect after 3 Weeks
of Coronary Angioplasty.
4. CLINICAL HISTORY
60 YR/M, SMOKER, NON-DM, NON-HTN
AWMI +STK+ ON 1.8.2011 WITHIN WINDOW
PERIOD OF 4 HRS AT A DISTRICT HOSPITAL
SOB AT REST
ON DAY 3-(3.8.2011)- PSM
ECG –AWMI
2D ECHO- VSD ; MODERATE LV DYSFUNCTION
REFERRED TO OUR HOSPITAL FOR FURTHER
MANAGEMENT
5. ON EXAMINATION-
KILLIP II & ANGINA AT REST
BP: 100/70 MMHG, PULSE :109/MIN, RR: 22/MIN, AFEBRILE
JVP: NORMAL, LV – S3+, PSM IV/VI
ROOM AIR ARTERIAL SAT. 95%
OTHER SYSTEMS : B/L BASILLIAR CREPTS
31. 1. Crenshaw BS, Granger CB, Birnbaum Y, Pieper KS, Morris DC, Kleiman NS, et al. Risk
factors, angiographic patterns, and outcomes in patients with ventricular septal defect
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2. Labrousse L, Choukroun E, Chevalier JM, Madonna F, Robertie F, Merlico F, et al.
Surgery for post infarction ventricular septal defect (VSD): risk factors for hospital death
and long term results. Eur J Cardiothorac Surg 2002;21:725-31.
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32. 6. Goldstein JA, Casserly IP, Balzer DT, Lee R, Lasala JM. Transcatheter closure of
recurrent postmyocardial infarction ventricular septal defects utilizing the Amplatzer
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Br J Hosp Med 1995;54:562-6.
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postinfarctional ventricular septal rupture. Ann Thorac Surg 1991;51:655-7.
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primary transcatheter closure of postinfarction ventricular septal defects. Eur Heart J 2009;
30:81-8.
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infarction ventricular septal defect with the Amplatzer septal occluder. Heart 1998; 80:522-4.
33. CASE REPORT
A 61-year-old male, hypertensive and diabetic for the past 20 years, was brought to
coronary care unit in CCF. He had sustained an anterior wall MI the previous day and was
thrombolyzed with streptokinase. On admission, pulse rate was 110/min and BP was
130/90 mm Hg. Auscultation revealed ……………….. Ajit S. Mullasari,*
MD,et.al.MMM,Chenai.
Catheterization and Cardiovascular Interventions 54:484–487 (2001)
34. Between Sep.2003 and Feb. 2008, 29 consecutive patients underwent primary
transcatheter VSD closure. Clinical, procedural, and outcome data were collected.
Patients were divided into those with and those without cardiogenic shock at
presentation for risk stratification.
The median follow-up time of surviving patients was 730 days. The median time
between VSD occurrence and closure was 1 day [interquartile range (IQR) 1–3]
the initial procedural success rate was 86%.
The shunt (Qp:Qs) could be reduced from 3.3 (IQR 2.3–3.8) to 1.4 (IQR 1.2–1.7; P , 0.001)
Procedure-related complications such as major residual shunting, LV rupture, and device
embolization occurred in 41%. The overall 30-day survival rate was 35%.
Mortality was higher for cardiogenic shock in comparison to non-shock patients (88 vs.
38%, P , 0.001).
Holger Thiele1*,et.al
35.
36. TAKE HOME MESSAGE
USE OF CARDIO-O-FIX DEVICE
INITIAL PTCAGAP OF 3 WEEKSVSD CLOSURE
AVOIDANCE OF GA,TEE,BALLOON SIZING.
NOT USED ANY STIFF GUIDE WIRE
MAKE THE PROCEDURE AS SIMPLE AS POSSIBLE WITH LEAST
EXPENDITURE