[Surgical results of postinfarction ventricular septal rupture]

Between 1981 and 1991, 17 consecutive patients underwent surgical repair of postinfarction ventricular septal rupture (VSR). 15 patients were operated upon during acute phase after the onset of VSR. Two patients were operated upon six weeks or more after the onset. Overall hospital mortality was 43% in the reviewed group. Our experience suggested that the number of the patients over 70 years of age increased and prevalence in VSR associated with the multivessel coronary artery disease was recognized. Despite improved surgical techniques and enhanced myocardial protection, our experience with surgical treatment of VSR was not as successful as we had hoped. Delay of operation is likely to produce hemodynamic instability and may increase operative mortality. In conclusion, the preoperative mechanical and pharmacological support should be performed, even if the patient is not so critically ill, and the earlier operation might lead to more favourable results in the surgery of the postmyocardial infarction ventricular septal rupture. In addition, preoperative coronary angiography for the precise evaluation of the coronary artery lesions might contribute to better results in the late phase of postoperative period.