<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-5633</journal-id>
<journal-title><![CDATA[Revista Colombiana de Cardiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Colomb. Cardiol.]]></abbrev-journal-title>
<issn>0120-5633</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Colombiana de Cardiologia. Oficina de Publicaciones]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-56332025000500333</article-id>
<article-id pub-id-type="doi">10.24875/rccar.25000021</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Comunicación interventricular multifenestrada en paciente con infarto agudo de miocardio con elevación del ST]]></article-title>
<article-title xml:lang="en"><![CDATA[Multifenestrated ventricular septal rupture in a patient with ST-segment elevation myocardial infarction]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Figueroa-Casanova]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Saavedra-Henao]]></surname>
<given-names><![CDATA[Juan D.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Labrador-Rosales]]></surname>
<given-names><![CDATA[José G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Romero-Daza]]></surname>
<given-names><![CDATA[Juan P.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-Cubillos]]></surname>
<given-names><![CDATA[Franky A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Salud Colombia Institución Universitaria Rector y Fundador ]]></institution>
<addr-line><![CDATA[Ibagué ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Clínica Avidanti Departamento de Cirugía Cardiovascular ]]></institution>
<addr-line><![CDATA[Ibagué ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Clinica Avidanti Departamento de Cardiologia ]]></institution>
<addr-line><![CDATA[Ibagué ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad del Tolima Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Ibagué ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2025</year>
</pub-date>
<volume>32</volume>
<numero>5</numero>
<fpage>333</fpage>
<lpage>338</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-56332025000500333&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-56332025000500333&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-56332025000500333&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Las complicaciones mecánicas posteriores a un infarto agudo de miocardio con elevación del ST (IAMCEST) son poco frecuentes en la actualidad gracias a la revascularización percutánea temprana. Una de las más graves es la ruptura del tabique interventricular, cuya incidencia se estima entre 0.17 y 0.21%. Su corrección puede realizarse por vía endovascular o mediante cirugía abierta. Se presenta el caso de un hombre de 70 años con dolor precordial opresivo, en quien se diagnosticó IAMCEST y se realizó angioplastia con stent medicado en la arteria descendente anterior. En el ecocardiograma de control se documentó un defecto interventricular multifenestrado, con tres orificios en la porción anteromedial. Dada la morfología del defecto, se efectuó cierre quirúrgico abierto con parche autólogo de pericardio, sin shunts residuales en el control ecocardiográfico. La mortalidad del IAMCEST aumenta significativamente ante complicaciones mecánicas, alcanzando hasta 73.6% en casos de ruptura septal. El abordaje endovascular suele asociarse a menor mortalidad, por lo que se considera inicialmente la opción de elección. Sin embargo, en defectos grandes, múltiples o sin bordes definidos, se prefiere la cirugía abierta. Esta puede realizarse mediante cierre directo con sutura o con la interposición de un parche, técnica utilizada en este caso.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Mechanical complications following ST-segment elevation myocardial infarction (STEMI) are now relatively rare due to the implementation of early percutaneous revascularization therapies. Ventricular septal rupture (VSR) occurs in 0.17-0.21% of cases and is corrected via either endovascular or open approaches. We present a case of a 70-year-old male patient with STEMI who, following coronary angioplasty, was diagnosed with a multifenestrated ventricular septal defect, subsequently repaired using an autologous pericardial patch. The patient presented with oppressive precordial chest pain and was diagnosed with STEMI. Angioplasty with a drug-eluting stent was performed on the left anterior descending artery. A follow-up echocardiogram revealed a ventricular septal defect with three openings located in the anteromedial portion of the interventricular septum. The defect was surgically closed via open approach using an autologous pericardial patch, with no evidence of residual shunt on follow-up echocardiogram. Mortality associated with STEMI increases significantly when mechanical complications, such as ventricular septal rupture, are present, with reported mortality rates of 73.6%. Initial evaluation of the defect should prioritize endovascular closure, as it has been associated with lower mortality compared to open repair. However, when the defect lacks well-defined borders, is large, or multifocal, open repair is preferred. Open repair techniques can be categorized into two main approaches: direct defect closure with continuous sutures or closure with a patch.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Defectos del tabique interventricular]]></kwd>
<kwd lng="es"><![CDATA[Infarto del miocardio]]></kwd>
<kwd lng="es"><![CDATA[Pericardio]]></kwd>
<kwd lng="es"><![CDATA[Ecocardiograma]]></kwd>
<kwd lng="en"><![CDATA[Ventricular septal defects]]></kwd>
<kwd lng="en"><![CDATA[Myocardial infarction]]></kwd>
<kwd lng="en"><![CDATA[Pericardium]]></kwd>
<kwd lng="en"><![CDATA[Echocardiogram]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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