Author + information
- Received March 17, 2012
- Accepted April 4, 2012
- Published online January 15, 2013.
A 52-year-old man presented in cardiogenic shock 3 days after experiencing an anteroseptal myocardial infarction and was found to have a large ventricular septal defect on transthoracic echocardiography. The free edge of the septum prolapsed into the right ventricle (A and B, arrows; Online Video 1). A left ventricular apical thrombus was also present. Three-dimensional transesophageal echocardiography demonstrated a 3.0 × 1.7-cm ovoid defect, with a rim of tissue adequate for deployment of an occluder device (C, arrow; Online Video 2). Under echocardiographic and fluoroscopic guidance, a multipurpose catheter was advanced across the aortic valve into the left ventricle, and a J-tip wire was advanced through the catheter and across the ventricular septal defect (D; Online Video 3). The wire was snared from the right-ventricular side and externalized via the femoral venous sheath. A 35-mm cribriform occluder was advanced across the wire and deployed successfully, with stabilization of the septum (E, arrow; Online Video 4). Agitated saline contrast injection demonstrated a minimal residual defect.
- Received March 17, 2012.
- Accepted April 4, 2012.
- American College of Cardiology Foundation