Long-Term Survival After Post-Myocardial Infarction Ventricular Septal Defect (VSD) Closure, Multiple Percutaneous Coronary Interventions and Edge-to-Edge Repair.

Abstract

This reports a case of a female aged 65 who presented in cardiogenic shock secondary to an inferior ST-elevation myocardial infarction and was diagnosed with a post-infarction ventricular septal defect (VSD) and was also found to have severe mitral valve regurgitation. She was not surgically operable, so underwent percutaneous VSD repair. Over the next 12 years she underwent multiple coronary stent procedures and presented with episodes of decompensated heart failure requiring edge-to-edge mitral valve repair. Despite having a low chance of survival and undergoing multiple high-risk procedures, she has survived over 12 years, with symptomaticimprovement. This demonstrates that even if patients present in what seems to be a futile clinical situation with post-infarction VSD, if they can survive the acute peri-infarct period they can survive for many years. Having survived the myocardial infarction, they can benefit from future interventions, as was the case for this patient who benefitted from edge-to-edge repair of the mitral valve to further improve her symptoms and prognosis.