Postinfarction ventricular septal rupture repair: Is it just a matter of the surgical technique?

Ronco, Daniele; Matteucci, Matteo; Massimi, Giulio; Mauro, Michele Di; Lorusso, Roberto

doi:10.1111/jocs.16149

Cited by 4 publications

(1 citation statement)

References 11 publications

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“…IABP, implantable turbine-pump and percutaneous cardiopulmonary bypass support are different cardiac assist devices commonly used today to stabilize patients with AMI ( 40 ). Indeed, the characteristics of maintaining preoperative patient stability and protecting the early perioperative course have led to the increasing acceptance of MCS in the treatment of patients with VSR by a growing number of physicians ( 16 , 41 , 42 ). In this study, the proportion of using IABP, CRRT and CVC in the death group is higher than that in the survival group, and most of the death group patients who rely on IABP support are difficult to go offline, which also shows that unlimited delayed surgery may cause unnecessary patients' pain and costs, especially for those relaying on mechanical assist.…”

Section: Discussionmentioning

confidence: 99%

Analysis of influencing factors for prognosis of patients with ventricular septal perforation: A single-center retrospective study

Duan

Zhao

et al. 2022

Front. Cardiovasc. Med.

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BackgroundVentricular septal rupture (VSR) is a type of cardiac rupture, usually complicated by acute myocardial infarction (AMI), with a high mortality rate and often poor prognosis. The aim of our study was to investigate the factors influencing the long-term prognosis of patients with VSR from different aspects, comparing the evaluation performance of the Gensini score, Sequential Organ Failure Assessment (SOFA) score and European Heart Surgery Risk Assessment System II (EuroSCORE II) score systems.MethodsThis study retrospectively enrolled 188 patients with VSR between Dec 9, 2011 and Nov 21, 2021at the First Affiliated Hospital of Zhengzhou University. All patients were followed up until Jan 27, 2022 for clinical data, angiographic characteristics, echocardiogram outcomes, intraoperative, postoperative characteristics and major adverse cardiac events (MACEs) (30-day mortality, cardiac readmission). Cox proportional hazard regression analysis was used to explore the predictors of long-term mortality.ResultsThe median age of 188 VSR patients was 66.2 ± 9.1 years and 97 (51.6%) were males, and there were 103 (54.8%) patients in the medication group, 34 (18.1%) patients in the percutaneous transcatheter closure (TCC) group, and 51 (27.1%) patients in the surgical repair group. The average follow-up time was 857.4 days. The long-term mortality of the medically managed group, the percutaneous TCC group, and the surgical repair group was 94.2, 32.4, and 35.3%, respectively. Whether combined with cardiogenic shock (OR 0.023, 95% CI 0.001–0.054, P = 0.019), NT-pro BNP level (OR 0.027, 95% CI 0.002–0.34, P = 0.005), EuroSCORE II (OR 0.530, 95% CI 0.305–0.918, P = 0.024) and therapy group (OR 3.518, 95% CI 1.079–11.463, P = 0.037) were independently associated with long-term mortality in patients with VSR, and this seems to be independent of the therapy group. The mortality rate of surgical repair after 2 weeks of VSR was much lower than within 2 weeks (P = 0.025). The cut-off point of EuroSCORE II was determined to be 14, and there were statistically significant differences between the EuroSCORE II < 14 group and EuroSCORE II≥14 group (HR = 0.2596, 95%CI: 0.1800–0.3744, Logrank P < 0.001).ConclusionPatients with AMI combined with VSR have a poor prognosis if not treated surgically, surgical repair after 2 weeks of VSR is a better time. In addition, EuroSCORE II can be used as a scoring system to assess the prognosis of patients with VSR.

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Section: Discussionmentioning

confidence: 99%

Analysis of influencing factors for prognosis of patients with ventricular septal perforation: A single-center retrospective study

Duan

Zhao

et al. 2022

Front. Cardiovasc. Med.

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Ventricular Septal Rupture After Myocardial Infarction

Cubeddu,

Lorusso,

Ronco

et al. 2024

Journal of the American College of Cardiology

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Ventricular septal defect complicating acute myocardial infarction: diagnosis and management. A Clinical Consensus Statement of the Association for Acute CardioVascular Care (ACVC) of the ESC, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the ESC Working Group on Cardiovascular Surgery

Schlotter,

Huber,

Hassager

et al. 2024

European Heart Journal

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Ventricular septal defects are a rare complication after acute myocardial infarction with a mortality close to 100% if left untreated. However, even surgical or interventional closure is associated with a very high mortality and currently no randomized controlled trials are available addressing the optimal treatment strategy of this disease. This state-of-the-art review and clinical consensus statement will outline the diagnosis, hemodynamic consequences and treatment strategies of ventricular septal defects complicating acute myocardial infarction with a focus on current available evidence and a focus on major research questions to fill the gap in evidence.

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Postinfarction ventricular septal rupture repair: Is it just a matter of the surgical technique?

Cited by 4 publications

References 11 publications

Analysis of influencing factors for prognosis of patients with ventricular septal perforation: A single-center retrospective study

Analysis of influencing factors for prognosis of patients with ventricular septal perforation: A single-center retrospective study

Ventricular Septal Rupture After Myocardial Infarction

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