Ventricular septal rupture following nonsurgical septal reduction for hypertrophic cardiomyopathy: Treatment with percutaneous closure

An 82‐year‐old woman with severe symptomatic hypertrophic obstructive cardiomyopathy undergoes nonsurgical septal reduction, leading to immediate hemodynamic and functional improvement. Five weeks later, she presents with severe biventricular failure due to a large septal rupture with marked left‐to‐right shunting. The rupture is closed with an Amplatzer post‐MI ventricular septal defect occluding device. Residual shunting through the device and a small residual shunt at its superior rim lead to severe hemolysis, which resolves spontaneously after 10 days of supportive therapy. A further self‐limiting episode of hemolysis recurred 3 months later following a period of excessive anticoagulation. Catheter Cardiovasc Interv 2004;61:411–414. © 2004 Wiley‐Liss, Inc.