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

The aim of this study was to explore the curative effect of Surgical repair Combining an Occluder and a Patch (SurCOP) procedure on postinfarction ventricular septal rupture and the related preoperative factors of death risk to assist clinical decision-making.

This retrospective multicentre study included patients with postinfarction ventricular septal rupture who underwent Surgical repair Combining an Occluder and a Patch (SurCOP) procedure from 2017 to 2025. Preoperative variables were analysed using univariable and multivariable logistic regression to identify independent risk factors for 30-day mortality.

A total of 60 patients were included. The 30-day mortality rate was 23.3%. Multivariable analysis identified older age (OR = 1.100, P = .032), higher preoperative creatinine (OR = 1.017, P = .017), and shorter time from acute myocardial infarction to surgery (OR = 0.894, P = .032) as independent risk factors. Mortality was highest (66.7%) when surgery occurred within 7 days of acute myocardial infarction, compared to 19.2% (7-14 days) and 17.8% (>14 days).

The Surgical repair Combining an Occluder and a Patch procedure, may enable earlier surgical intervention in patients with ventricular septal rupture. Given that advanced age, high preoperative creatinine, and a shorter acute myocardial infarction to surgery time are independent risk factors for early death, delaying surgery until around 1-week post-acute myocardial infarction-when haemodynamically tolerated-is a strategy that may improve outcomes.