Postmyocardial infarction ventricular septal rupture in the thrombolytic era: two-year experience at a regional...

We review the 2-year experience in one cardiology unit of postmyocardial infarction ventricular septal rupture. Between July 1990 and July 1992 there were 23 such patients for whom records were available, 20 of whom underwent surgical repair. The overall mortality was 48%, and the operative mortality was 40%. The mortality in patients who suffered septal rupture within 48 hours of acute myocardial infarction was 82%, while in those in whom rupture was delayed for more than 48 hours the mortality was 17% (P < 0.001). Despite a local thrombolytic rate of 75% in acute myocardial infarction, only 5 out of 23 had received thrombolytic therapy. In this centre, postinfarction septal rupture is a common reason for emergency referral. Survival in those presenting more than 48 hours after infarction is good; in those presenting earlier the prognosis remains poor, despite surgery.