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Updated: Dec 27, 2025
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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
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Outcomes of Early Versus Delayed Transcatheter Closure of Post-Myocardial Infarction Ventricular Septal Defect
Mark R Heckle1, Jeremy A Brooksbank2, Manyoo A Agarwal3
1Division of Cardiovascular Diseases, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States of America.
Summary
Early transcatheter repair of post myocardial infarction ventricular septal defect (VSD) is linked to worse 30-day survival. Delayed repair shows significantly better outcomes, suggesting timing is critical for VSD treatment.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Post myocardial infarction ventricular septal defect (VSD) is a rare but severe complication.
- Surgical repair of VSDs carries a high mortality rate, and optimal treatment remains unclear.
Purpose of the Study:
- To compare 30-day survival rates between early and late primary transcatheter repair of post myocardial infarction VSD.
Main Methods:
- A systematic literature search was conducted using SCOPUS for case reports and series on transcatheter closure of post-MI VSD.
- Included studies reported VSD closure timing and 30-day survival; early repair was defined as closure within 14 days of VSD diagnosis, late repair after 14 days.
Main Results:
- Analysis of 126 patients from 27 publications revealed an overall 30-day survival rate of 62.7%.
- Early repair (within 14 days) had a 30-day survival of 36.2%, significantly lower than late repair (85.3%, P < .01).
- Early repair was associated with larger Qp:Qs ratios, larger occluder sizes, and lower successful repair rates.
Conclusions:
- Early transcatheter VSD repair after myocardial infarction is associated with worse 30-day survival compared to delayed repair.
- Further research is necessary to establish the optimal timing for transcatheter VSD repair in post-MI patients.
