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J Thorac Cardiovasc Surg 2008;135:951-952
© 2008 The American Association for Thoracic Surgery

Brief Communication

Left ventricular assist device as a bridge to surgery in postinfarction ventricular septal defect

Antonis A. Pitsis, MD, FETCS, FESCa,*, Timotheos G. Kelpis, MDa, Aikaterini N. Visouli, MDa, Georgios Bobotis, MDb, Gerasimos S. Filippatos, MD, FCCP, FESCc, Dimitrios T. Kremastinos, MD, FESC, FACCc

a Thessaloniki Heart Institute, St Luke's Hospital, Thessaloniki, Greece
b Cardiology Department, Papageorgiou Hospital, Thessaloniki, Greece
c Cardiology Department, Athens University Hospital Attikon, Athens, Greece

Received for publication November 5, 2007; accepted for publication December 4, 2007.

* Address for reprints: Antonis A. Pitsis, MD, FETCS, FESC, Thessaloniki Heart Institute, St Luke's Hospital, Panorama, 55236, Thessaloniki, Greece. (Email: apitsis@otenet.gr).

The first 20% of the full text of this article appears below.

Clinical Summary

A 43-year-old man was transferred to Thessaloniki Heart Institute 15 days after an anterior wall myocardial infarction. He presented in cardiogenic shock with reinfarction and a large left-to-right shunt with intra-aortic balloon pump (IABP) and inotropic support. Physical examination revealed a loud holosystolic murmur that was best heard at the left lower sternal border. Electrocardiography findings were consistent with an anterior myocardial infarction. Transesophageal echocardiography demonstrated a large anterior postinfarction ventricular septal defect (PVSD) (Go Figure 1, A). Coronary angiography showed an ostial occlusion of the left anterior descending artery. The patient was transferred to the operating theater; a median sternotomy was performed, and the pericardial cavity was entered. An extensive hematoma was visualized in the anterior wall of the left ventricle and the free wall of the right ventricle (Go Figure 2, A). It became immediately apparent that a primary repair was at a . . . [Full Text of this Article]






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