Modified Infarct Exclusion Technique for Repair of Postinfarction Ventricular Septal Rupture

Parachuri, V Rao; Tripathy, Amit Kumar; Gaikwad, Namdeo Mahadeo; Singh, A; Mahajan, Vineet; Niranjan, S.

doi:10.1016/j.athoracsur.2018.09.045

Cited by 10 publications

(16 citation statements)

References 6 publications

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“…Recently, numerous modifications of the surgical techniques have been proposed: two patches with or without gelatin-resorcin-formalin, threepatch technique, local applications of adhesives, etc. (12)(13)(14)(15). Regrettably, these techniques tend to be more complicated, and the reproducibility issue is of utmost concern.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, percutaneous transcatheter closure (TCC) has emerged as an alternative to surgical closure of VSR but is mainly restricted to selected cases in which patients have small VSR in the subacute or chronic phase (9)(10)(11). Besides, some surgical modifications have been proposed but appear less promising due to the lack of the repeatability and effectiveness confirmed by other researchers (12)(13)(14)(15). Current treatments for VSR vary greatly, but the results remain disappointing.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Contemporary Prognosis of Ventricular Septal Rupture Complicating Acute Myocardial Infarction: A Single-Center Experience

Wang

Xiao

Liu

et al. 2021

Front. Cardiovasc. Med.

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Objectives: Ventricular septal rupture (VSR) is a rare but lethal complication of acute myocardial infarction (AMI). We conducted a retrospective analysis of the clinical characteristics of VSR patients and explored the risk factors for long-term mortality.Methods: In this single-center cohort study, 127 patients diagnosed with post-AMI VSR between May 2012 and April 2019 were included. Demographic, clinical, operative, and outcome data were collected. The 30-day and long-term mortality were outcomes of interest. Cox proportional hazard regression analysis was used to explore the predictors of long-term mortality.Results: The mean age of the VSR cohort was 66.6 ± 8.7 years, 67 (52.8%) were males. Among the 127 patients, 78 patients (61.4%) were medically managed, 31 (24.4%) patients underwent percutaneous transcatheter closure (TCC), and 18 (14.2%) patients received surgical repair. The median follow-up time was 1129 days [interquartile range: 802–2019 days]. The 30-day mortality of the medically managed group, percutaneous TCC group, and surgical management group was 93.6, 22.6, and 11.1%, respectively; and the long-term mortality was 96.2, 25.8, and 22.2%, respectively. VSR repair treatment including surgical management (HR 0.01, 95% CI 0.001–0.09, p < 0.001) and percutaneous TCC (HR 0.09, 95% CI 0.03–0.26, p < 0.001) was associated with a better prognosis, and cardiogenic shock (CS) (HR 9.30, 95% CI 3.38–25.62, p < 0.001) was an independent risk factor of long-term mortality.Conclusions: The prognosis of VSR patients without operative management remains poor, especially in those complicated with CS. Timely and improved surgery treatment is needed for better outcomes in VSR patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Contemporary Prognosis of Ventricular Septal Rupture Complicating Acute Myocardial Infarction: A Single-Center Experience

Wang

Xiao

Liu

et al. 2021

Front. Cardiovasc. Med.

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“…Some patients received direct VSR patch repair (Dagget) (11) due to evident fibrosis of the rupture site. The majority of VSR patients, however, were subjected to the classical infarct exclusion technique (David) (12) or the modified David procedure (13,14). Bovine pericardium mesh of appropriate size was selected to better preserve the left ventricular geometry.…”

Section: Surgical Techniquementioning

confidence: 99%

Outcomes of surgical repair of anterior or posterior ventricular septal rupture after myocardial infarction

Fu¹,

Wu²,

Ma³

et al. 2022

Cardiovasc Diagn Ther

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Background: Ventricular septal rupture (VSR) is a rare and fatal complication of myocardial infarction.Surgery is the main treatment for the condition. It is currently believed that surgery is less effective for posterior VSR than for anterior VSR. The objective of this study was to investigate the clinical outcomes of surgical treatment for myocardial infarction combined with an anterior or posterior VSR.Methods: This was a single-center, retrospective, observational, cohort study. Clinical data of 68 patients with myocardial infarction combined with VSR were retrospectively analyzed. According to the site of the VSR, patients were divided into the anterior (43 cases) and posterior (25 cases) VSR groups, and the general clinical data, preoperative examination results, surgery, and follow-up results were compared between the two groups.Results: Compared with the anterior VSR group, the operative time in the posterior VSR group was longer {300 [240, 360] vs. 360 [300, 400] min; P=0.003}, and the cardiopulmonary bypass time was longer (142.0±52.2 vs. 180.2±52.3 min; P=0.005), and the aortic clamp time was longer (84.0±32.5 vs. 115.9±39.8 min; P=0.001).There were no significant differences in the incidence of perioperative complications, including bleeding, low cardiac output, pulmonary, and cerebrovascular complications, and the incidence of perioperative death between the two groups (P>0.05). The patients were followed up for 1.0-10.5 (median, 4.2) years. There were no significant differences in the survival rate and the incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) including myocardial infarction, heart failure, revascularization, and cerebrovascular events between the two groups (P>0.05). Conclusions:The perioperative risks and medium-and long-term outcomes of the surgical repair of anterior or posterior VSR after myocardial infarction were similar.

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“…The hospital mortality rate for patients undergoing surgery was 45%, and the hospital mortality rate for patients receiving drug treatment was 90% [1] . With the advent of the era of thrombolysis, the incidence of ventricular septal rupture after acute myocardial infarction has dropped significantly, only 0.17-0.31% [1,2]. The emergence of emergency reperfusion strategies (including thrombolysis and PCI) makes VSR Patients benefit from [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…As for the mechanism of myocardial infarction combined with ventricular septal rupture, it is not yet clear. Therefore, the purpose of this study is to: (1) compare the clinical and angiographic characteristics of patients with VSR after AMI and determine the risk factors of patients with VSR after AMI; (2) The evaluation includes the effect of the treatment plan for patients with VSR after AMI, and determines the related risk factors after VSR after AMI and the related factors that affect the prognosis.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Risk Factors of Acute Myocardial Infarction Combined with Ventricular Septal Rupture

Zhang¹,

Chen²,

Liu³

et al. 2022

Journal of Clinical Trials & Experimental Studies

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Objective:To analyze the clinical characteristics and risk factors of ventricular septal rupture (VSR) after acute myocardial infarction (AMI).Methods: A total of 2090 cases of acute myocardial infarction and 63 cases of acute myocardial infarction combined with ventricular septal perforation were collected from Fuwai Huazhong Cardiovascular Hospital from September 2017 to January 2021. 189 cases of type 1 acute myocardial infarction were randomly selected according to the ratio of 1:3 as a control group, the patients collected and analyzed clinical data, the risk factors of AMI and VSR.Results: Compared with the control group, the age, female, serum creatinine, serum potassium, serum magnesium, N-terminal B-type natriuretic peptide (NT-proBNP), LDH1, hemoglobin, total protein, and albumin were higher in the ventricular septal rupture group , Serum chloride ion, and low blood pressure at admission, the difference was statistically significant (P<0.01 or 0.05). The results of multivariate logistic regression analysis showed that glycosylated hemoglobin (OR=1.66, 95%CI 1.04-2.95, p=0.03) was related to the mortality of ventricular septal rupture after myocardial infarction; age> 60 years, gender, diseased blood vessels, albumin<35g/L, SBP<90mmHg, LVEF<40%, LVESD is related to ventricular septal rupture after acute myocardial infarction (all p<0.01 or 0.05). Conclusion: elderly, female, left anterior descending artery disease, hypotension, low protein Patients with acute myocardial infarction with hyperemia, hypochloremia, and left ventricular systolic dysfunction are prone to ventricular septal rupture.

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Modified Infarct Exclusion Technique for Repair of Postinfarction Ventricular Septal Rupture

Cited by 10 publications

References 6 publications

Clinical Characteristics and Contemporary Prognosis of Ventricular Septal Rupture Complicating Acute Myocardial Infarction: A Single-Center Experience

Clinical Characteristics and Contemporary Prognosis of Ventricular Septal Rupture Complicating Acute Myocardial Infarction: A Single-Center Experience

Outcomes of surgical repair of anterior or posterior ventricular septal rupture after myocardial infarction

Analysis of Risk Factors of Acute Myocardial Infarction Combined with Ventricular Septal Rupture

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