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Acquired ventricular septal defect.

D J Keenan, J L Monro, J K Ross

    The Journal of Thoracic and Cardiovascular Surgery
    |January 1, 1983
    PubMed
    Summary
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    Surgical repair of ventricular septal rupture after myocardial infarction offers a 63% survival rate. Early intervention and avoiding inferior infarction complications improve outcomes for heart attack patients.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Cardiovascular Research

    Background:

    • Ventricular septal rupture (VSR) is a rare but serious complication of myocardial infarction (MI).
    • Prompt diagnosis and surgical intervention are critical for patient survival.
    • Understanding risk factors and optimal timing for surgery is essential.

    Purpose of the Study:

    • To review the surgical outcomes of VSR complicating MI over a 9-year period.
    • To identify factors influencing mortality and survival rates.
    • To emphasize the importance of surgical awareness for this complication.

    Main Methods:

    • Retrospective review of 36 patients surgically treated for VSR post-MI.
    • Analysis of mortality rates based on infarction location, time to operation, and concomitant procedures.

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  • Evaluation of the impact of intra-aortic balloon pump (IABP) use and cardiogenic shock.

    • Main Results:

    • Overall early mortality was 28% (10 deaths), with an 8-year actuarial survival rate of 63%.
    • Mortality was higher for inferior MIs (38%) versus anterior MIs (13%).
    • Operating within 2 weeks of infarction led to higher mortality (43%) compared to operating after 2 weeks (18%).
    • Concomitant procedures (CABG, aneurysmectomy) did not increase mortality.
    • Patients with cardiogenic shock had a 47% mortality rate.
    • IABP use (44% of patients) aided in managing critically ill patients.

    Conclusions:

    • Surgical treatment for VSR post-MI yields a 63% long-term survival rate.
    • Early operation (under 2 weeks) and inferior MI location are associated with increased mortality.
    • Awareness of VSR as a complication and the benefits of surgical intervention is crucial for clinicians managing MI patients.