1.Successful Repair of Ventricular Septal Rupture with Impella Support: A Report of Two Cases
Kohei HACHIRO ; Noriyuki TAKASHIMA ; Kenichi KAMIYA ; Masahide ENOMOTO ; Yasuo KONDO ; Fumihiro MIYASHITA ; Hodaka WAKISAKA ; Kentaro MATSUOKA ; Komei KADO ; Tomoaki SUZUKI
Japanese Journal of Cardiovascular Surgery 2024;53(6):339-342
Ventricular septal rupture （VSR） is a rare but still possibly catastrophic complication of acute myocardial infarction. We report two successful cases of Impella-assisted VSR. In case 1, a 78-year-old woman was transferred to our hospital with a diagnosis of posterior VSR. After Impella insertion, cardiac output increased from 2.13 to 2.57 and the pulmonary to systemic output ratio decreased from 2.92 to 1.78. Two days after insertion of Impella, she underwent surgery. In case 2, an 89-year-old woman was transferred to our hospital with a diagnosis of anterior VSR. After Impella insertion, cardiac output increased from 2.29 to 2.85, but the pulmonary to systemic output ratio changed little from 3.79 to 3.81. Three days after insertion of Impella, she underwent surgery. Neither patient experience hemodynamic deterioration preoperatively. Postoperative echocardiography showed no residual shunt in either case. Impella for VSR seemed effective in stabilizing hemodynamics preoperatively and postoperatively.
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