mechanism of ventricular septal rupture ppt

Mechanism of vsr

1. Etiology VSR post MI The most common cause of ventricular septal rupture is full-thickness (transmural) myocardial infarction in one of the following coronary arteries: LAD coronary artery; supplies most of the anterior portion of the interventricular septum. It can lead to apical VSR. Dominant RCA; supplies the most inferior portion of the interventricular septum. This can lead to a basal VSR. The dominant LCx ; supplies the posterior portion of the posterior descending artery and arises from the circumflex branch. Partial-thickness infarcts such as non-ST elevation myocardial infarction or unstable angina can also increase the risk of ventricular septal rupture.

2. Risk Factor VSR post MI Older, female, hypertensive, have chronic kidney disease First myocardial infarction (MI) in the background of delayed or absent reperfusion therapy. Angiography usually reveals an absence of collateral circulation to the infarct zone.

3. Management of VSR Jones BM, Kapadia SR, Smedira NG, et al. Ventricular septal rupture complicating acute myocardial infarction: a contemporary review. Eur Heart J 2014;35:2060-8.

4. Mortality and Timing of Repair Jones BM, Kapadia SR, Smedira NG, et al. Ventricular septal rupture complicating acute myocardial infarction: a contemporary review. Eur Heart J 2014;35:2060-8.