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Post-Infarction Ventricular Septal Defect: A quarter century experience
Ahmed Al-Bulushi1, Issa Al Salmi2, Ahmed Ramadan Ahmed1
1Cardio-Thoracic and.
Sultan Qaboos University Medical Journal
|January 1, 2024
Summary
Surgical repair of post-infarction ventricular septal defect (VSD) shows high early mortality. Predictors of mortality include concomitant coronary issues and posterior rupture. Long-term survival is impacted by coronary disease and residual shunts.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Post-infarction ventricular septal defect (VSD) is a serious complication of acute myocardial infarction.
- Surgical repair is a treatment option, but outcomes require further investigation.
Purpose of the Study:
- To investigate the clinical outcomes and survival rates after surgical repair of VSD.
- To identify predictors of early and long-term mortality in patients undergoing VSD repair.
Main Methods:
- Retrospective study of 75 patients undergoing VSD repair from 1996 to 2020 in Oman.
- Analysis of patient demographics, surgical details, and follow-up data.
Main Results:
- The study included 75 patients (62.5% male, mean age 59 years) with a mean follow-up of 17.2 years.
- Early mortality within 30 days was high at 45.3%.
- Five-year and 10-year survival rates were 41.3% and 33.3%, respectively. Predictors of 30-day mortality included coronary involvement, anastomoses, residual shunt, and dialysis.
Conclusions:
- Despite surgical repair, early mortality for post-infarction VSD remains high.
- Early repair and posterior rupture location are predictors of early mortality.
- Long-term survival is compromised by pre-existing coronary artery disease, renal failure, and residual postoperative shunts.
