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Iatrogenic ventricular septal defect: A rare complication of surgical reconstruction of mitral paravalvular dehiscence

INTRODUCTION: Iatrogenic ventricular septal defect is a rare complication after the surgical replacement of cardiac valves. Small defects may have no hemodynamic significance or remain unremarked at the end of the surgical procedure. Understanding of the valvular anatomy alone is not always enough t...

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Autores principales: Rashed, Aref, Gombocz, Karoly, Fulop, Janos, Alotti, Nasri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011176/
https://www.ncbi.nlm.nih.gov/pubmed/27591383
http://dx.doi.org/10.1016/j.ijscr.2016.08.024
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author Rashed, Aref
Gombocz, Karoly
Fulop, Janos
Alotti, Nasri
author_facet Rashed, Aref
Gombocz, Karoly
Fulop, Janos
Alotti, Nasri
author_sort Rashed, Aref
collection PubMed
description INTRODUCTION: Iatrogenic ventricular septal defect is a rare complication after the surgical replacement of cardiac valves. Small defects may have no hemodynamic significance or remain unremarked at the end of the surgical procedure. Understanding of the valvular anatomy alone is not always enough to avoid such complications, especially in the hands of young surgeons. PRESENTATION OF CASE: We present a case of iatrogenic ventricular septal defect that developed early after the surgical closure of a hemodynamically significant mitral paravalvular leak. Although the patient's critical state did not allow surgical intervention and he died, we think the lessons drawn from this case could be helpful to avoid such horrible complications in the future. DISCUSSION: This case documents a rare disastrous complication after imperfect surgical closure of a mitral paravalvular leak. Despite the unfortunate end, in reporting this case we try to direct the light to the possible mechanisms that led to the development of this injury focusing on the embryological and anatomical background. CONCLUSION: Understanding the anatomical and embryological structure of the cardiac fibrotic skeleton should keep cardiac surgeons more vigilent in detecting iatrogenic ventricle septal defects before the development of a devastating hemodynamic state.
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spelling pubmed-50111762016-09-13 Iatrogenic ventricular septal defect: A rare complication of surgical reconstruction of mitral paravalvular dehiscence Rashed, Aref Gombocz, Karoly Fulop, Janos Alotti, Nasri Int J Surg Case Rep Case Report INTRODUCTION: Iatrogenic ventricular septal defect is a rare complication after the surgical replacement of cardiac valves. Small defects may have no hemodynamic significance or remain unremarked at the end of the surgical procedure. Understanding of the valvular anatomy alone is not always enough to avoid such complications, especially in the hands of young surgeons. PRESENTATION OF CASE: We present a case of iatrogenic ventricular septal defect that developed early after the surgical closure of a hemodynamically significant mitral paravalvular leak. Although the patient's critical state did not allow surgical intervention and he died, we think the lessons drawn from this case could be helpful to avoid such horrible complications in the future. DISCUSSION: This case documents a rare disastrous complication after imperfect surgical closure of a mitral paravalvular leak. Despite the unfortunate end, in reporting this case we try to direct the light to the possible mechanisms that led to the development of this injury focusing on the embryological and anatomical background. CONCLUSION: Understanding the anatomical and embryological structure of the cardiac fibrotic skeleton should keep cardiac surgeons more vigilent in detecting iatrogenic ventricle septal defects before the development of a devastating hemodynamic state. Elsevier 2016-08-31 /pmc/articles/PMC5011176/ /pubmed/27591383 http://dx.doi.org/10.1016/j.ijscr.2016.08.024 Text en © 2016 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Rashed, Aref
Gombocz, Karoly
Fulop, Janos
Alotti, Nasri
Iatrogenic ventricular septal defect: A rare complication of surgical reconstruction of mitral paravalvular dehiscence
title Iatrogenic ventricular septal defect: A rare complication of surgical reconstruction of mitral paravalvular dehiscence
title_full Iatrogenic ventricular septal defect: A rare complication of surgical reconstruction of mitral paravalvular dehiscence
title_fullStr Iatrogenic ventricular septal defect: A rare complication of surgical reconstruction of mitral paravalvular dehiscence
title_full_unstemmed Iatrogenic ventricular septal defect: A rare complication of surgical reconstruction of mitral paravalvular dehiscence
title_short Iatrogenic ventricular septal defect: A rare complication of surgical reconstruction of mitral paravalvular dehiscence
title_sort iatrogenic ventricular septal defect: a rare complication of surgical reconstruction of mitral paravalvular dehiscence
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011176/
https://www.ncbi.nlm.nih.gov/pubmed/27591383
http://dx.doi.org/10.1016/j.ijscr.2016.08.024
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