medigraphic.com
ISSN 0188-2198 (Impreso)

2014, Número 2

Siguiente >>

Rev Mex Cardiol 2014; 25 (2)


Cierre percutáneo primario del defecto del tabique interventricular postinfarto con el dispositivo de Amplatzer: resultados inmediatos y seguimiento a largo plazo

Palacios-Rodríguez JM, Muñiz GA, Bonfil FMA, De la Cruz OR, Galván GE, Cantú RS

Idioma: Español
Referencias bibliográficas: 37
Paginas: 65-72
Archivo PDF: 266.41 Kb.


RESUMEN

Introducción: La reparación quirúrgica inmediata de una comunicación interventricular que complica el infarto agudo del miocardio (CIV post-IAM) se asocia con la alta mortalidad. El cierre con dispositivo percutáneo parece ser seguro y efectivo en pacientes con CIV post-IAM; reportamos los resultados inmediatos y a largo plazo en la utilización del dispositivo Amplatzer en el cierre primario de una CIV post-IAM. Material y métodos: De junio del 2006 a enero del 2014, 17 pacientes portadores de una CIV post-IAM se sometieron a un cierre percutáneo con Amplatzer a una edad promedio de 66.8 ± 5.5, 82.4% en shock cardiogénico (ShC), el 35.3% recibieron tratamiento trombolítico (TT) en ventana, el tiempo promedio del diagnóstico de CIV al cierre percutáneo (IP) fue de 8.7 ± 5.8 días. Resultados: Con un seguimiento actual de 13.25 ± 12.6 meses, el éxito del procedimiento fue del 100%, el shunt (QP:QS) se redujo de 2.9 ± 0.95 a 1.5 ± 0.40 L/min p = 0.0001, 12 pacientes (70.6%) se sometieron a una Angioplastía Coronaria Transluminal Percutánea (ACTP) del vaso culpable posterior al cierre de la CIV. La mortalidad a 30 días fue de 52.9%, siendo más alta en el paciente con ShC versus no-ShC 64.3 versus 0% p = 0.043 OR 2.8 (IC 95% 1.38-5.6). Conclusión: El cierre primario de CIV post-IAM es una técnica muy promisoria que puede ser realizada con una alta tasa de éxito y mínimas complicaciones y puede ser tomado como una alternativa a la cirugía. Sin embargo, a pesar de ser una técnica menos invasiva, la mortalidad permanece alta y muy evidente en el paciente en ShC.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Topaz O, Taylor AL. Interventricular septal rupture complicating acute myocardial infarction: from pathophysiologic features to the role of invasive and noninvasive diagnostic modalities in current management. Am J Med. 1992; 93: 683-688.

  2. López-Sendón J, Gurfinkel EP, López de Sa E, Agnelli G, Gore JM, Steg PG et al. Global Registry of Acute Coronary Events (GRACE) investigators. Factors related to heart rupture in acute coronary syndromes in the Global Registry of Acute Coronary Events. Eur Heart J. 2010; 31: 1449-1456.

  3. 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 complicating acute myocardial infarction. GUSTO-I (Global utilization of streptokinase and TPA for occluded coronary arteries) trial investigators. Circulation. 2000; 101: 27-32.

  4. Slater J, Brown RJ, Antonelli TA, Menon V, Boland J, Col J et al. Cardiogenic shock due to cardiac free-wall rupture or tamponade after acute myocardial infarction: a report from the shock trial registry. Should we emergently revascularize occluded coronaries for cardiogenic shock? J Am Coll Cardiol. 2000; 36: 1117-1122.

  5. Thiele H, Dähnert I, Schuler G. Magnetic resonance imaging after percutaneous closure of a ventricular septal defect complicating myocardial infarction. Eur Heart J. 2006; 27: 1136.

  6. Lowe HC, Jang IK, Yoerger DM, MacGillivray TE, de Moor M, Palacios IF. Compassionate use of the Amplatzer ASD closure device for residual postinfarction ventricular septal rupture following surgical repair. Catheter Cardiovasc Interv. 2003; 59: 230-233.

  7. Holzer R, Balzer D, Amin Z, Ruiz CE, Feinstein J, Bass J 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: 196-201.

  8. Deja MA, Szostek J, Widenka K, Szafron B, Spyt TJ, Hickey MS et al. Post infarction septal defect: can we do better? Eur J Cardiothorac Surg. 2000; 18: 194-201.

  9. Caputo M, Wilde P, Angelini GD. Management of postinfarction ventricular septal defect. Br J Hosp Med. 1995; 54: 562-566.

  10. Lee EM, Roberts DH, Walsh KP. Transcatheter closure of a residual postmyocardial infarction ventricular septal defect with the Amplatzer septal occluder. Heart. 1998; 80: 522-524.

  11. Dellborg M, Held P, Swedberg K, Vedin A. Rupture of the myocardium: occurrence and risk factors. Br Heart J. 1985; 54: 11-16.

  12. Lemery R, Smith HC, Giuliani ER, Gersh BJ. Prognosis in rupture of the ventricular septum after acute myocardial infarction and role of early surgical intervention. Am J Cardiol. 1992; 70: 147-151.

  13. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction-executive summary. Circulation. 2004; 110: 588-636.

  14. Van de Werf F, Ardissino D, Betriu A, Cokkinos DV, Falk E, Fox KA et al. Management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2003; 24: 28-66.

  15. Gaudiani VA, Miller DG, Stinson EB, Oyer PE, Reitz BA, Moreno-Cabral RJ et al. Postinfarction ventricular septal defect: an argument for early operation. Surgery. 1981; 89: 48-55.

  16. Moreyra AE, Huang MS, Wilson AC, Deng Y, Cosgrove NM, Kostis JB. MIDAS study group (MIDAS 13). Trends in incidence and mortality rates of ventricular septal rupture during acute myocardial infarction. Am J Cardiol. 2010; 106: 1095-100.

  17. Madsen JC, Daggett WM. Repair of postinfarction ventricular septal defects. Semin Thorac Cardiovasc Surg. 1998; 10: 117-127.

  18. Ozkara A, Cetin G, Mert M, Yildiz CE, Arat A, Akçevin A et al. Postinfarction ventricular septal rupture: surgical intervention and risk factors influencing hospital mortality. Acta Cardiol. 2005; 60: 213-217.

  19. Thiele H, Lauer B, Hambrecht R, Boudriot E, Sick P, Niebauer J et al. Short- and long-term hemodynamic effects of intra-aortic balloon support in ventricular septal defect complicating acute myocardial infarction. Am J Cardiol. 2003; 92: 450-454.

  20. Kaulfersch C, Daehnert I, Schuler G, Thiele H. Transcatheter closure of postinfarction ventricular septal defects. Minerva Cardioangiol. 2007; 55: 693-701.

  21. Thiele H, Kaulfersch C, Daehnert I, Schoenauer M, Eitel I, Borger M et al. Immediate primary transcatheter closure of postinfarction ventricular septal defects. Eur Heart J. 2009; 30: 81-88.

  22. Masura J, Gavora P, Formanek M. Transcatheter closure of secundum atrial septal defects using the new self-centering Amplatzer septal occluder; initial human experience. Cathet Cardiovasc Diagn. 1997; 42: 388-393.

  23. Holzer R, Balzer D, Amin Z, Ruiz CE, Feinstein J, Bass J 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: 196-201.

  24. Pesonen E, Thien U, Sandstrom S et al. Transcatheter closure of post-infarction ventricular septal defect with the Amplatzer septal occlude device. Scand Cardiovasc J. 2000; 34: 446-448.

  25. Chessa M, Carminati M, Cao QL et al. Transcatheter closure of congenital and acquired muscular ventricular septal defects using the Amplatzer device. J Invas Cardiol. 2002; 14: 322-327.

  26. Fortin DF, Sheikh KH, Kisslo J. The utility of echocardiography in the diagnostic strategy of postinfarction ventricular septal rupture: a comparison of two-dimensional echocardiography versus Doppler color flow imaging. Am Heart J. 1991; 121: 25-32.

  27. Konstantinides S, Geibel A, Kasper W, Just H. Noninvasive estimation of right ventricular systolic pressure in postinfarction ventricular septal rupture: an assessment of two Doppler echocardiographic methods. Crit Care Med. 1997; 25: 1167-1174.

  28. Lock JE, Block PC, McKay RG, Baim DS, Keane JF. Transcatheter closure of ventricular septal defects. Circulation. 1988; 78: 361-368.

  29. Edwards BS, Edwards WD, Edwards JE. Ventricular septal rupture complicating acute myocardial infarction: identification of simple and complex types in 53 autopsied hearts. Am J Cardiol. 1984; 54: 1201-1205.

  30. Kitamuta S, Mendez A, Kay JH. Ventricular septal defect following myocardial infarction: experience with surgical repair through a left ventriculotomy and review of literature. J Thorac Cardiovasc Surg. 1971; 61: 186-199.

  31. Cummings RG, Reimer KA, Califf R, Hackel D, Boswick J, Lowe JE. Quantitative analysis of right and left ventricular infarction in the presence of postinfarction ventricular septal defect. Circulation. 1988; 77: 33-42.

  32. Held AC, Cole PL, Lipton B, Gore JM, Antman EM, Hochman JS et al. Rupture of the interventricular septum complicating acute myocardial infarction: a multicenter analysis of clinical findings and outcome. Am Heart J. 1988; 116: 1330-1336.

  33. Moore CA, Nygaard TW, Kaiser DL, Cooper AA, Gibson RS. Postinfarction ventricular septal rupture: the importance of location of infarction and right ventricularm function in determining survival. Circulation. 1986; 74: 45-55.

  34. Radford MJ, Johnson RA, Daggett WM Jr, Fallon JT, Buckley MJ, Gold HK et al. Ventricular septal rupture: a review of clinical and physiologic features and an analysis of survival. Circulation. 1981; 64: 545-553.

  35. David TE, Armstrong S. Surgical repair of postinfarction ventricular septal defect by infarct exclusion. Semin Thorac Cardiovasc Surg. 1998; 10: 105-110.

  36. Mantovani V, Mariscalco G, Leva C, Blanzola C, Sala A. Surgical repair of postinfarction ventricular septal defect: 19 years of experience. Int J Cardiol. 2006; 108: 202-206.

  37. Arnaoutakis GJ, Zhao Y, George TJ, Sciortino CM, McCarthy PM, Conte JV. Surgical repair of ventricular septal defect after myocardial infarction: outcomes from the Society of Thoracic Surgeons National Database. Ann Thorac Surg. 2012; 94: 436-444.




2020     |     www.medigraphic.com