Surgical Repair of Post-Infarction Ventricular Septal Defect　- Findings From a Japanese National Database

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Databases

Background:

• Ventricular septal defect (VSD) is a rare but fatal complication following myocardial infarction (MI).
• Surgical repair outcomes for post-MI VSD are critical due to high mortality.
• Understanding patient characteristics and operative results is essential for improving care.

Purpose of the Study:

• To analyze patient demographics and surgical outcomes for post-myocardial infarction VSD repair.
• To identify risk factors associated with operative death in this patient population.
• To provide insights into the management of post-MI VSD using national data.

Main Methods:

• Retrospective review of the Japan Adult Cardiovascular Surgery Database (JCVSD) from 2008-2014.
• Inclusion of adult patients (≥18 years) who underwent surgical repair of post-MI VSD.
• Analysis of operative death as the primary outcome, with multivariable analysis for risk factors.

Main Results:

• 1,397 patients with post-MI VSD underwent surgical repair.
• Overall operative mortality was 33.0%, with higher rates in urgent (30.9%) and emergency/salvage (40.6%) cases.
• Advanced age and emergency/salvage surgical status were strongly associated with increased operative death.

Conclusions:

• Post-myocardial infarction VSD remains a devastating complication with significant mortality.
• Surgical outcomes are heavily influenced by patient age and the urgency of surgical intervention.
• Effective management strategies are needed to improve survival rates for post-MI VSD.