Risk factors and outcome analysis after surgical management of ventricular septal rupture complicating acute myocardial infarction: A retrospective analysis

Shih Ming Huang, Shu Chien Huang, Chih Hsien Wang, I. Hui Wu, Nai Hsin Chi, Hsi Yu Yu, Ron Bin Hsu, Chung I. Chang, Shoei Shen Wang, Yih Sharng Chen

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Background: Ventricular septal rupture (VSR) is an uncommon but well-recognized mechanical complication of acute myocardial infarction (AMI). The outcome of VSR remains poor even in the era of reperfusion therapy. We reviewed our experience with surgical repair of post-infarction VSR and analyzed outcomes in an attempt to identify prognostic factors. Methods: From October 1995 to December 2013, data from 47 consecutive patients (mean age, 68 ± 9.5 years) with post-infarction VSR who underwent surgical repair at our institute were retrospectively reviewed. The preoperative conditions, morbidity and surgical mortality were analyzed. Multivariate analysis was subsequently carried out by constructing a logistic regression model in order to identify independent predictors of postoperative mortality. Long term survival function were estimated using the Kaplan-Meier method and compared using the log-rank test. Results: Percutaneous coronary intervention was performed in 17 (36.2%) patients, intra-aortic balloon pump (IABP) was used in 34 (72.3%), and six (12.8%) were supported with extracorporeal membrane oxygenation (ECMO) preoperatively. Forty-one (87.2%) patients received emergent surgical treatment. Concomitant coronary artery bypass grafting was performed in 27 (57.4%) patients. Conclusions: Post-infarction VSR remains a serious and challenging complication of AMI in the modern surgical era. The EuroSCORE II can be used for an approximate prediction of operative mortality. Preserved LVEF was associated with better prognosis, while the need for postoperative RRT was associated with higher early and late mortality. Besides, the strategy of total revascularization should be applied to ensure long-term survival benefit.

Original languageEnglish
Article number66
JournalJournal of Cardiothoracic Surgery
Volume10
Issue number1
DOIs
Publication statusPublished - 2015 May 4

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Risk factors and outcome analysis after surgical management of ventricular septal rupture complicating acute myocardial infarction: A retrospective analysis'. Together they form a unique fingerprint.

Cite this