Background: Postinfarction ventricular septal rupture (VSR) is an uncommon but challenging mechanical complication for surgeons. This study analyzed the impacts of rupture size on surgical outcomes in patients with VSR.Methods: During a 15-year period, from January 2006 to December 2020, 112 patients underwent repairs of postinfarction VSR. Patient clinical data, including angiographic and echocardiographic findings, operative procedures, early morbidity and mortality, and survival time were collated. Univariable and multivariable analyses were performed to identify the risk factors of 30-day mortality.
Results:The 30-day mortality rate was 7.1% for the whole cohort. The mean survival time estimate was 147.2 months [95% confidence interval (CI): 135.6 to 158.9 months], with a 3-year survival rate of 91.2% and a 5-year survival rate of 89.0%. Multivariable analysis revealed that rupture enlargement rate is an independent risk factor of 30-day mortality. The receiver operating characteristic (ROC) curve indicated that the rupture enlargement rate could predicted the 30-day mortality with high accuracy.Conclusions: Delayed surgery may be considered for patients who respond well to aggressive treatment.The rupture enlargement rate is an independent risk factor for postoperative 30-day morality in patients with delayed VSR repair. Furthermore, the rupture enlargement rate has good predictive value for the prognosis of VSR patients.
Objective: The aim of the study was to analyze the impact of rupture
size on surgical outcomes of ventricular septal rupture. Methods: During
a 15-year period, from Jan 2006 to Dec 2020, 112 patients underwent
repairs of postinfarction ventricular septal rupture. Data were
collected on clinical, angiographic, and echocardiographic findings;
operative procedures; early morbidity and mortality; and survival time.
Univariable and multivariable analyses were performed to identify risk
factors of 30-day mortality. Results: Thirty-day mortality was 7.1% for
the whole cohort. The mean survival time estimate was 147.2 (95% Cl
135.6-158.9) months, with a 3-year survival rate of 91.2% and a 5-year
survival rate of 89.0%. Multivariable analysis regarded rupture
enlargement gradient as an independent risk factor of 30-day mortality.
The ROC curve indicated that rupture enlargement gradient predicted
30-day mortality with high accuracy. Conclusions: Delayed surgery could
be considered for patients who respond well to aggressive treatment.
Rupture enlargement gradient is an independent risk factor for
postoperative 30-days morality of delayed VSR repair and has good
predictive power for the prognosis of VSR patients.
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