Gassenmaier Tobias, Gorski Armin, Aleksic Ivan, Deubner Nikolas, Weidemann Frank, Beer Meinrad
Tobias Gassenmaier, Meinrad Beer, Department of Radiology, University Hospital Wuerzburg, 97080 Wuerzburg, Germany.
World J Cardiol. 2013 May 26;5(5):151-3. doi: 10.4330/wjc.v5.i5.151.
A 74-year-old man was admitted to the cardiac catheterization laboratory with acute myocardial infarction. After successful angioplasty and stent implantation into the right coronary artery, he developed cardiogenic shock the following day. Echocardiography showed ventricular septal rupture. Cardiac magnet resonance imaging (MRI) was performed on the critically ill patient and provided detailed information on size and localization of the ruptured septum by the use of fast MRI sequences. Moreover, the MRI revealed that the ventricular septal rupture was within the myocardial infarction area, which was substantially larger than the rupture. As the patient's condition worsened, he was intubated and had intra-aortic balloon pump implanted, and extracorporeal membrane oxygenation was initiated. During the following days, the patient's situation improved, and surgical correction of the ventricular septal defect could successfully be performed. To the best of our knowledge, this case report is the first description of postinfarction ventricular septal rupture by the use of cardiac MRI in an intensive care patient with cardiogenic shock and subsequent successful surgical repair.
一名74岁男性因急性心肌梗死入住心脏导管实验室。在成功对右冠状动脉进行血管成形术和支架植入术后，他在第二天出现了心源性休克。超声心动图显示室间隔破裂。对这名重症患者进行了心脏磁共振成像（MRI）检查，并通过快速MRI序列提供了有关破裂间隔大小和位置的详细信息。此外，MRI显示室间隔破裂位于心肌梗死区域内，该区域比破裂处大得多。随着患者病情恶化，他接受了插管并植入了主动脉内球囊泵，并启动了体外膜肺氧合。在接下来的几天里，患者的情况有所改善，并成功进行了室间隔缺损的手术矫正。据我们所知，本病例报告是首次描述在一名患有心源性休克的重症监护患者中使用心脏MRI诊断心肌梗死后室间隔破裂并随后成功进行手术修复的情况。
