Perfil clínico-cirúrgico de pacientes operados por ruptura do septo interventricular pós-infarto do miocárdioClinical and surgical profile of patients operated for postinfarction ventricular septal rupture .9% (n = 13) were male. Rupture occurred on average 4.8 days after infarction. Cardiogenic shock was observed in 57.1% (n = 12), being risk factor for death (100% with shock vs 22,2% without shock; P<0.001). Survivors had a higher mean ejection fraction compared to deaths (66.29% ± 4.61% versus 42.71% ± 4.79%, P <0.001). All were classified as high risk by the EuroSCORE, and the survivors had lower mean score compared to deaths (6.57 ± 0.53 versus 10.93 ± 2.23; p <0.001). The majority (76.2%, n = 16) needed to use vasoactive drugs and 57.1% (n = 12) considered hemodynamically unstable. The need for vasoactive drugs was a risk factor for death (81.3% in the vasoactive drugs group versus 20% without vasoactive drugs group, P = 0.025). Hemodynamic instability was also a risk factor for death (100% in the unstable group versus 22.2% in the stable group; P <0.001). The rate of in-hospital mortality was 66.7% (n = 14).Conclusions: The need for vasoactive drugs, hemodynamic instability and cardiogenic shock were associated with higher rates of mortality. Patients who had adverse outcomes had less ventricular function and higher score in the EuroSCORE. Mortality rate remains high.Descriptors: Heart Septal Defects. Heart Rupture, PostInfarction. Myocardial Infarction.
342SÁ, MPBO ET AL -Clinical and surgical profile of patients operated for postinfarction ventricular septal rupture Bras Cir Cardiovasc 2010; 25(3): 341-349
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