The SurCOP Procedure for Ventricular Septal Rupture: Analysis of Outcomes and Preoperative Risk Factors to Guide...

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Critical Care Medicine

Background:

• Postinfarction ventricular septal rupture (VSR) is a life-threatening complication of acute myocardial infarction.
• Early surgical intervention is often necessary but carries significant risks.
• The Surgical repair Combining an Occluder and a Patch (SurCOP) procedure offers a potential treatment option.

Purpose of the Study:

• To evaluate the effectiveness of the SurCOP procedure for postinfarction VSR.
• To identify preoperative risk factors associated with mortality after SurCOP.
• To inform clinical decision-making for managing postinfarction VSR.

Main Methods:

• Retrospective analysis of 60 patients undergoing SurCOP for postinfarction VSR (2017-2025).
• Univariable and multivariable logistic regression used to identify independent risk factors for 30-day mortality.
• Analysis of preoperative variables including age, creatinine levels, and time from myocardial infarction to surgery.

Main Results:

• The 30-day mortality rate was 23.3%.
• Independent risk factors for mortality included older age, higher preoperative creatinine, and shorter time from acute myocardial infarction to surgery.
• Mortality was significantly higher (66.7%) when surgery occurred within 7 days of myocardial infarction compared to later intervals.

Conclusions:

• The SurCOP procedure can facilitate earlier surgical intervention for VSR.
• Advanced age, elevated creatinine, and early surgical timing (<7 days post-MI) are associated with increased early mortality.
• Delaying surgery until approximately one week after myocardial infarction, if hemodynamically feasible, may improve patient outcomes.