Related Experiment Video
Updated: Apr 25, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Long-term outcome after transcatheter closure of postinfarction ventricular septal rupture
Johan Heiberg1, Vibeke Elisabeth Hjortdal, Jens Erik Nielsen-Kudsk
1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus N, Denmark.
Insights
Transcatheter closure of postinfarction ventricular septal rupture (VSR) shows promising long-term survival rates. This minimally invasive approach offers a viable alternative to surgery, with lower mortality compared to historical surgical outcomes.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Ventricular septal rupture (VSR) is a severe complication of myocardial infarction.
- Transcatheter closure is an emerging alternative to surgical VSR repair.
- Long-term outcomes data for transcatheter VSR closure are limited.
Purpose of the Study:
- To evaluate long-term all-cause mortality following transcatheter closure of postinfarction VSR.
- To assess procedure-related complication rates in patients undergoing transcatheter VSR closure.
- To compare outcomes with historical surgical closure data.
Main Methods:
- Retrospective analysis of 9 patients undergoing transcatheter VSR closure from 2000-2013.
- Primary device closure was selected due to surgical contraindications.
- Key endpoints included 30-day, 1-year, and 5-year mortality and survival duration.
Main Results:
- The cohort mean age was 75.1 years; median time to closure was 16 days.
- 30-day, 1-year, and 5-year mortality rates were 11.1%, 33.3%, and 62.5%, respectively.
- Mean survival was 4.6 years; 3 patients remained alive at follow-up.
Conclusions:
- Transcatheter VSR closure at a single tertiary center demonstrated favorable short- and long-term mortality.
- Outcomes appear comparable to existing limited reports on transcatheter VSR closure.
- This approach may offer a survival benefit compared to historical surgical interventions.
Objectives:
We report the long-term all-cause mortality and procedure-related complication rate following transcatheter closure of postinfarction ventricular septal rupture (VSR) in a single tertiary center.
Background:
VSR is an exceedingly serious and deathly complication to myocardial infarction. Surgical closure has previously been the treatment of choice, but in the last decade a transcatheter approach has gained ground. However, reports on long-term survival are still sparse and experience is often restricted to large tertiary centers with high flow of patients.
Methods:
From January 2000 to April 2013, 9 patients underwent transcatheter closure of a VSR at Aarhus University Hospital. Primary device closure was chosen mainly because of significant risk factors against surgery. Our major endpoints were 30-day, 1-year, and 5-year mortality and years of survival until time of evaluation.
Results:
Our cohort had a mean age of 75.1 ± 8.4 years, and the median time from VSR to closure was 16 days (2-346). The 30-day, 1-year, and 5-year mortality rates were 11.1%, 33.3%, and 62.5%, respectively. Mean time of postprocedural survival was 4.6 ± 4.4 years at the time of review. Three patients were still alive at the time of review, 1 with a shock-index <1 at the time of VSR closure.
Conclusions:
As a single medium-sized tertiary center, we report lower short- and long-term mortality rates compared with most published data on outcome after surgical closure. Our results are comparable to the few previously published reports on transcatheter closure of postinfarction VSRs.
