• Internal medicine · Nov 2024

    Case Reports

    A Case of Myocardial Infarction with Non-obstructive Coronary Arteries Complicated by a Ventricular Septal Rupture: The Challenge of Achieving Hemodynamic Stability Using Impella Devices.

    • Masashi Yokoi, Tsuyoshi Ito, Yu Kawada, Junki Yamamoto, Toshiyuki Yamada, Shohei Kikuchi, Shuichi Kitada, Toshihiko Goto, Hideo Hattori, Hisao Suda, and Yoshihiro Seo.
    • Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Japan.
    • Intern. Med. 2024 Nov 15; 63 (22): 306530703065-3070.

    AbstractThe prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA) is reported to be as worse as myocardial infarction with obstructive coronary arteries. However, its mechanical complications are still poorly understood. A 71-year-old woman developed MINOCA after ascending aortic replacement surgery. During treatment, the patient experienced cardiogenic shock due to a ventricular septal rupture (VSR). The introduction of Impella devices reduced the left-to-right shunt and improved the patient's hemodynamics. Finally, a scheduled surgical repair was performed under stable conditions. In this report, we focused on the pathophysiology of MINOCA-related VSR and discussed the effectiveness of Impella devices as a bridge to surgical repair and circulatory backup during the perioperative period.

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