[Percutaneous treatment of post-acute myocardial infarction mechanical complications: state of the art]. / Trattamento percutaneo delle complicanze meccaniche dell'infarto miocardico acuto: stato dell'arte.

Left ventricular free wall rupture, ventricular pseudoaneurysm, papillary muscle rupture and ventricular septal rupture are life-threatening mechanical complications of acute myocardial infarction. Despite significant improvements over the last decades in overall mortality for patients with myocardial infarction, the outcome of subjects who develop post-infarction mechanical complications remains poor. Surgical treatment is considered the standard of care. However, percutaneous approaches (such as pericardial fibrin-glue injection for left ventricular free wall rupture, transcatheter edge-to-edge mitral repair for papillary muscle rupture and device closure for ventricular pseudoaneurysm or septal rupture) have been proposed in selected high-risk or inoperable patients, or in subjects with ideal characteristics for feasibility, as therapeutic alternatives to open surgery. The aim of the present review is to provide a comprehensive overview of the percutaneous strategies for the management of post-acute myocardial infarction mechanical complications.

Surgical repair of postinfarction ventricular septal rupture: current state of the art.

The incidence of postacute myocardial infarction ventricular septal rupture (post-AMI VSR) has decreased over the past two decades. Nevertheless, individuals who suffer from post-AMI VSR continue to represent a subgroup of patients with high morbidity and mortality. The care for these patients is complex and requires a multidisciplinary approach. However, because of the small number of reports that exist to guide clinical practice, there is a significant variability in care among centers. This review summarizes information on post-AMI VSR diagnosis and outline contemporary best management and practice consideration.