Rutilio D. Jiménez-Espinosa, Servicio o Departamento, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
Ana L. Hernández-Pérez, Servicio de Anestesiología, Centro Médico ABC, Ciudad de México, México
Naomi Muñoz-Macías, División de Cirugía Cardíaca, Unidad Médica de Alta Especialidad, Hospital de Cardiología Centro Médico Nacional S. XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
Viviana Y. Perea-Gaitán, Anestesia Cardiovascular, Unidad Médica de Alta Especialidad de Cardiología, Centro Médico Nacional Siglo XXI, Ciudad de México, México
Post-infarction ventricular septal defect (PIVC) is the mechanical complication after acute myocardial infarction with the highest mortality in our setting. Surgery continues to be the treatment of choice for this disease, and despite this, overall mortality does not drop below 40%. Early diagnosis is essential to prevent the patient from suffering circulatory collapse and early death. We present the case of a 78-year-old male with a medial post-infarction PIVC and left ventricular filling pressure and left ventricular ejection fraction of 40%. In the first hours in the intensive care unit, he presented cardiogenic shock and acute kidney injury that required balloon pump, after 3 days he was intervened to close the PIVC, which was successful, without complications and with satisfactory evolution. The aim of this article is to present a surgical repair of a PIVC defect using the combined David and Dagget technique, with resection of necrotic tissue and its exclusion with an endocardial patch.
Keywords: Postinfarction ventricular septal defect. Cardiogenic shock. Cardiovascular surgery. Cardiovascular anesthesia.