Changes in Hospital Mortality Rates in 425 Patients With Acute ST-Elevation Myocardial Infarction and Cardiac Rupture Over a 30-Year Period

Figueras, Jaume; Alcalde, Óscar; Barrabés, José A.; Serra, Viçens; Alguersuari, Joan; Cortadellas, Josefa; Lidón, Rosa‐Maria

doi:10.1161/circulationaha.108.776690

Cited by 247 publications

(229 citation statements)

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“…In addition, in keeping with other studies, our patients had also other risk factors of VSR including arterial hypertension, lack of previous history of CAD, anterior localization of AMI, single-vessel CAD and delayed treatment after the onset of AMI symptoms [2][3][4][5][6]. This suggests, that pathophysiology of AMI-related VSR involves sudden, severe ischemia, which in turn leads to extensive myocardial necrosis.…”

Section: Discussionsupporting

confidence: 80%

“…In our patients' cases VSR was detected 24 and 48 hours respectively after AMI onset which indicates the trend towards an earlier occurrence of the VSR [1]. Since the introduction of myocardial reperfusion therapies the incidence of AMI-related VSR has been reduced to 0,25-0,7% [3].…”

Section: Discussionsupporting

confidence: 56%

“…Despite significant improvements in overall mortality for patients with acute myocardial infarction (AMI) the outcome of patients who develop ventricular septal rupture (VSR) remains poor [1][2][3]. Cardiogenic shock and severe left ventricular failure are the most important factors determining the outcome of individuals with VSR [4].…”

Section: Introductionmentioning

confidence: 99%

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Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Therapeutic Strategy to Choose?

Polak¹,

Jander²,

Kidawa³

et al. 2017

J Clin Exp Cardiolog

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Ventricular septal rupture is still a rare but often fatal complication of acute myocardial infarction. Emergent surgical closure of postinfarction ventricular septal rupture irrespective of the clinical status has been the standard treatment so far. A percutaneous approach using an occluder device is a less invasive option and allows immediate complete closure after initial hemodynamic stabilization. Furthermore immediate reduction of the left-to-right shunt, even if the ventricular septal rupture is not completely closed, may stabilize the patient enough to function as a bridge to surgery. We present two similar cases of patients which highlight the multiple features of acute myocardial infarction-related ventricular septal rupture treated with two alternative techniques.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 56%

See 1 more Smart Citation

Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Therapeutic Strategy to Choose?

Polak¹,

Jander²,

Kidawa³

et al. 2017

J Clin Exp Cardiolog

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“…Тем не менее смертность при этом остается на высоком уровне из-за продолжающейся кровопотери, длительного ИК и пережатия аорты. Использование Та-хоКомба также хорошо зарекомендовало себя при пласти-ке поверхностного эпикардиального повреждения сердца без выраженного кровотечения из полости желудочка [28][29][30][31][32][33]. Локальные гемостатики играют важную роль и в лечении травм и проникающих ранений сердца.…”

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“…Использование ИК имеет определенные преимущества: стабилизация гемодинами-ки, возможность контроля давления внутри ЛЖ, сухое операционное поле и защита миокарда при кардиоплегии. Изолированное применение ТахоКомба обычно нецелесо-образно при постинфарктных разрывах с формированием больших дефектов стенки ЛЖ [29][30][31]. Несмотря на то что K. Nishizaki и соавт.…”

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TachoСomb in practice of cardiovascular surgeon

Белов¹,

Чарчян²,

Belov³

et al. 2016

Kardiol. serdechno-sosud. khir.

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Surgical Treatment of Postinfarction Ventricular Septal Rupture

et al. 2021

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IMPORTANCE Ventricular septal rupture (VSR) is a rare but life-threatening mechanical complication of acute myocardial infarction associated with high mortality despite prompt treatment. Surgery represents the standard of care; however, only small single-center series or national registries are usually available in literature, whereas international multicenter investigations have been poorly carried out, therefore limiting the evidence on this topic. OBJECTIVESTo assess the clinical characteristics and early outcomes for patients who received surgery for postinfarction VSR and to identify factors independently associated with mortality. DESIGN, SETTING, AND PARTICIPANTS The Mechanical Complications of Acute Myocardial Infarction: an International Multicenter Cohort (CAUTION) Study is a retrospective multicenter international cohort study that includes patients who were treated surgically for mechanical complications of acute myocardial infarction. The study was conducted from January 2001 to December 2019 at 26 different centers worldwide among 475 consecutive patients who underwent surgery for postinfarction VSR. EXPOSURES Surgical treatment of postinfarction VSR, independent of the technique, alone or combined with other procedures (eg, coronary artery bypass grafting). MAIN OUTCOMES AND MEASURESThe primary outcome was early mortality; secondary outcomes were postoperative complications. RESULTSOf the 475 patients included in the study, 290 (61.1%) were men, with a mean (SD) age of 68.5 (10.1) years. Cardiogenic shock was present in 213 patients (44.8%). Emergent or salvage surgery was performed in 212 cases (44.6%). The early mortality rate was 40.4% (192 patients), and it did not improve during the nearly 20 years considered for the study (median [IQR] yearly mortality, 41.7% [32.6%-50.0%]). Low cardiac output syndrome and multiorgan failure were the most common causes of death (low cardiac output syndrome, 70 [36.5%]; multiorgan failure, 53 [27.6%]). Recurrent VSR occurred in 59 participants (12.4%) but was not associated with mortality. Cardiogenic shock (survived: 95 [33.6%]; died, 118 [61.5%]; P < .001) and early surgery (time to surgery Ն7 days, survived: 105 [57.4%]; died, 47 [35.1%]; P < .001) were associated with lower survival. At multivariate analysis, older age (odds ratio [

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Changes in Hospital Mortality Rates in 425 Patients With Acute ST-Elevation Myocardial Infarction and Cardiac Rupture Over a 30-Year Period

Cited by 247 publications

References 38 publications

Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Therapeutic Strategy to Choose?

Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Therapeutic Strategy to Choose?

TachoСomb in practice of cardiovascular surgeon

Surgical Treatment of Postinfarction Ventricular Septal Rupture

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