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Postinfarction Ventricular Septal Defect: The Role of Three‐Dimensional Echocardiography

Figure 1. Postinfarction ventricular septal defect diagnosis. Images acquired 3 days after admission to hospital for acute myocardial infarction. A. Three-dimensional transesophageal echocardiographic full-volume image, orientated to be viewed from the right ventricle, showing the precise site of rupture (arrow). B. Threedimensional transesophageal echocardiographic full-volume color Doppler image, orientated to be viewed from the right ventricle, showing the precise site of rupture. Although in the last few years the incidence of postinfarction ventricular septal defect (PIVSD) has been decreasing due to thrombolysis and early intervention, the management of this rare and life-threatening condition remains challenging.1 Despite some technical problems, transcatheter implantation of Amplatzer occluders is an attractive treatment option for high-risk patients suffering from subacute PIVSD.2 Ventricular septal defects complicating acute myocardial infarction are often characterized by complex anatomy and irregular shape so that, in order to perform the most adequate treatment, a comprehensive echocardiographic evaluation is needed. Bidimensional (2D) echocardiography is