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[Simultaneous surgical correction of complicated forms of myocardial infarct--ventricular septal defect and
Insights
Surgical intervention for postinfarction ventricular septal defect and left ventricular aneurysm offers improved survival rates. Early operative treatment is crucial for managing this severe cardiac complication.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Research
Context:
- Postinfarction ventricular septal defect (VSD) and left ventricular aneurysm are severe complications following myocardial infarction.
- These conditions present significant challenges in patient management and prognosis.
Purpose:
- To evaluate the outcomes of surgical intervention versus drug therapy in patients with postinfarction VSD and left ventricular aneurysm.
- To define optimal patient selection criteria and surgical strategies for these complex cases.
Summary:
- A study of 13 patients (ages 46-68) with postinfarction VSD and left ventricular aneurysm compared surgical treatment (6 patients) with drug therapy (7 patients).
- Drug therapy resulted in high mortality (6/7 deaths within 78 days). Surgical patients showed better outcomes, with 5/6 discharged in satisfactory condition, though one early postoperative death occurred.
- Late survival after surgery reached 83% at 3 years.
Impact:
- Surgical management demonstrates a significant survival benefit compared to conservative drug therapy for postinfarction VSD and left ventricular aneurysm.
- The findings provide evidence-based guidance for selecting patients and determining the extent of surgical intervention, improving long-term outcomes.
Abstract:
Thirteen patients with postinfarction ventricular septal defect and aneurysm of the left ventricle are discussed. Their ages ranged from 46 to 68 years. Six of them underwent operation in periods ranging from 22 days to 11 months, seven were given drug therapy. Six of these seven died from acute cardiac insufficiency or recurrent myocardial infarction in periods of 8 to 78 days; one patient died in 10 months. Five of the six patients who were operated on were discharged from the clinic in a satisfactory condition, one female patient died in the early postoperative period from acute left-ventricular insufficiency. Late survival (follow-up of 3 years) was 83%. The method for selecting the patients for operative treatment and the necessary volume of the intervention are specified.