Терапевтический архив (Sep 2023)

Right ventricle free wall rupture during transcatheter occluder implantation in a patient with postinfarction rupture of the interventricular septum and COVID-19-associated myocarditis. Case report

  • Dmitry V. Pevzner,
  • Tatiana S. Sukhinina,
  • Egor N. Anufriev,
  • Natalia S. Kostritca,
  • Eric A. Avetisyan,
  • Victor N. Shitov,
  • Ella V. Kurilina,
  • Aleksandr G. Osiev,
  • Evgeny V. Merkulov,
  • Andrew S. Tereshchenko,
  • Sergey A. Boytsov

DOI
https://doi.org/10.26442/00403660.2023.07.202330
Journal volume & issue
Vol. 95, no. 7
pp. 574 – 579

Abstract

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Intraventricular septum rupture is a rare mechanic complication of myocardial infarction associated with high mortality. This case describes STEMI in recovered patient after COVID 19 associated pneumonia, which was complicated by ventricular septum rupture followed by cardiogenic shock. It was managed by percutaneous occluder implantation. The procedure was complicated by right ventricular wall rupture. Postmortem examination of myocardium showed the signs of inflammation infiltrate and myocyte necrosis, according to histopathological Dallas criteria diagnosis of COVID-19 associated myocarditis was established. The COVID-19 pandemic has contributed to increasing cardiovascular mortality. This is typically attributed to diminishing resources for timely and appropriate medical care, and patients late presentations for fear of contracting the infection. Cardiovascular complication of COVID-19 may be another contributing factor. Further research is needed to improve our understanding of the mechanisms and long-term sequelae of myocardium damage in COVID-19, to optimize treatment strategy and subsequent follow-up in such patients.

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