Alkhawam Mustafa, Ebrahimi Ali J, Nanda Navin C, Ahmed Mustafa I
Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA.
JACC Case Rep. 2025 Aug 6;30(22):104573. doi: 10.1016/j.jaccas.2025.104573.
Ventricular septal rupture (VSR) post myocardial infarction (MI) is a rare, high-risk complication requiring urgent intervention. Fusion imaging (FI), integrating echocardiography and fluoroscopy, offers a novel approach for percutaneous closure in unstable patients.
A 60-year-old man developed cardiogenic shock and basal VSR after inferior MI stent placement. Echocardiography confirmed the defect with a left-to-right shunt. Using FI, percutaneous closure with a 16-mm Amplatzer device was completed under real-time guidance. Post-procedure imaging revealed a well-seated device with minimal residual shunt.
Overlaying echocardiographic imaging on fluoroscopy enhances procedural precision and can reduce radiation and procedural time. This case represents FI-guided post-MI VSR closure.
TAKE-HOME MESSAGES: FI enables rapid, accurate percutaneous procedures in critically ill patients, minimizing procedural time and risks. We present our experience using FI to reduce crossing attempts and improve device deployment accuracy in a critically ill patient with VSR.
心肌梗死（MI）后室间隔破裂（VSR）是一种罕见的高风险并发症，需要紧急干预。融合成像（FI）结合了超声心动图和荧光透视检查，为不稳定患者的经皮闭合提供了一种新方法。
一名60岁男性在置入下壁心肌梗死支架后发生心源性休克和基底VSR。超声心动图证实了缺损伴有左向右分流。使用FI，在实时引导下用16毫米的Amplatzer装置完成了经皮闭合。术后成像显示装置位置良好，残余分流极小。
将超声心动图成像叠加在荧光透视检查上可提高手术精度，并可减少辐射和手术时间。本病例代表了FI引导下的心肌梗死后VSR闭合。
FI能够在危重症患者中快速、准确地进行经皮手术，将手术时间和风险降至最低。我们展示了在一名患有VSR的危重症患者中使用FI减少穿刺尝试次数并提高装置植入准确性的经验。
