Repair of Ruptured Interventricular Septum Complicating Acute Myocardial Infarction

Shickman, Martin D.; Fields, Josh; Pearce, Morton Lee

doi:10.1001/archinte.1959.00270010146019

Cited by 27 publications

(3 citation statements)

References 20 publications

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“…Survivals of 4-5 years have been reported by Wood and Livezey ( 3 5 ) and Zucker et al (36). The diagnosis has sometimes been made by catheterization (6, 11,19,27). None of our patients survived so long (table 111).…”

Section: Discussionsupporting

confidence: 51%

Perforation of the Interventricular Septum in Myocardial Infarction: A Study Based upon an Autopsy Material

Lundberg

Söderström

1962

Journal of Internal Medicine

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Section: Discussionsupporting

confidence: 51%

Perforation of the Interventricular Septum in Myocardial Infarction: A Study Based upon an Autopsy Material

Lundberg

Söderström

1962

Journal of Internal Medicine

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“…Catheter findings in post-infarction rupture of the interventricular septum have been reported by numerous authors (Muller et al, 1950;Cooley et al, 1957;Gottsegen et al, 1957;Shickman, Fields, and Pearce, 1959;Gerbaux et al, 1960;Rubenstein and Levinson, 1961;Boicourt et al, 1962;Bressie et al, 1962;Collis et al, 1962;Dobell et al, 1962;Lee, Cardon, and Slodki, 1962;Payne, Hunt, and Kirklin, 1963;Davison et al, 1964). All those six patients whose defects were later successfully repaired had left-to-right shunts of 2-7:1 or more (Boicourt et al, 1962;Bressie et al, 1962;Collis et al, 1962;Davison et al, 1964;Payne et al, 1963; and our case).…”

Section: Repair Of Acquired Ventricular Septal Defect After Myocardiamentioning

confidence: 70%

Successful early repair of acquired ventricular septal defect after myocardial infarction.

Honey¹,

Belcher²,

Hasan³

et al. 1967

Heart

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Successful repair of an acquired ventricular septal defect following myocardial infarction was first reported in 1962. Recently Barnard and Kennedy (1965) have reviewed 14 patients with post-infarction ventricular septal defect in whom surgical closure was attempted; 7 survived more than 6 weeks after operation. They found that those whose defects were closed 5 weeks or more after infarction survived the operation, but that those requiring emergency operation soon after infarction died. The best long-term results were obtained in those whose operations were delayed 3 months or more. However, more than 90 per cent of all patients die within a year of septal rupture, and most of these die within 2 months (Sanders, Kern, and Blount, 1956). It is clear that surgical repair should be considered in all patients who have a hemodynamically significant shunt through an acquired ventricular septal defect; ideally this should be done at least 6 and preferably 12 weeks after infarction, but, in view of the very high early mortality on medical treatment, nothing can be lost by attempting closure at an earlier stage if the patient is deteriorating.The following report concerns a patient in whom the defect was successfully repaired 27 days after infarction, and 20 days after the presumed time of septal rupture. Case ReportA man, aged 52, had left-sided chest pain, with nausea and sweating, on September 10, 1965. On September 17, he was more breathless and had a fainting episode; on this occasion his doctor heard a loud pracordial systolic murmur for the first time.On admission to the Whittington Hospital on September 20 under the care of Dr. T. St M. Norris, he was pale and sweating with a regular tachycardia and a raised venous pressure. The blood pressure was 120/100 453 mm. Hg. The heart was not clinically enlarged but a loud pansystolic murmur with thrill was loudest in the fourth left intercostal space near the sternum. There were bilateral basal rales, and a chest x-ray film showed pulmonary venous congestion with a small right pleural effusion. The electrocardiogram showed a recent posterior myocardial infarct. The diagnosis of ruptured interventricular septum was made; he improved at first on routine medical treatment, but signs of right-sided heart failure increased, and he was transferred to the London Chest Hospital on September 28 for consideration of surgical repair.At this time he was orthopnceic, and had signs of congestive cardiac failure with raised jugular venous pressure (10 cm.), enlarged tender liver, and cedema of both ankles. The pulse was rapid (110/min.) and the blood pressure 130/100 mm. Hg. The murmur and thrill were unchanged. He had several carious teeth and gross gingival infection. The chest x-rayfilm showed no cardiac enlargement (CTR 48%); there was severe pulmonary congestion with bilateral hilar and basal clouding and small pleural effusions. The electrocardiogram showed normal sinus rhythm; Q waves, slightly raised ST segments, and inverted T waves in leads II, III, aVF, V6, and V7 indicated...

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“…The definitive treatment of an acquired ventricular septal defect is surgical closure (Schickman, Fields, and Pearce, 1959;Boicourt et al, 1962;Payne, Hunt, and Kirklin, 1963). It has been said that the optimum time for repair of these lesions is six to eight weeks after perforation when the edges of the defect are well delineated and enough fibrous tissue has developed to facilitate a secure closure (Dobell, Scott, Cronin, and Reid, 1962;Collis, Mackinnon, Raison, and Whittaker, 1962;Davison et al, 1964;Allen and Woodwark, 1966).…”

mentioning

confidence: 99%

Surgical considerations in the treatment of acute acquired ventricular septal defect

Gonzalez‐Lavin

Zajtchuk

1971

Thorax

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Repair of Ruptured Interventricular Septum Complicating Acute Myocardial Infarction

Cited by 27 publications

References 20 publications

Perforation of the Interventricular Septum in Myocardial Infarction: A Study Based upon an Autopsy Material

Perforation of the Interventricular Septum in Myocardial Infarction: A Study Based upon an Autopsy Material

Successful early repair of acquired ventricular septal defect after myocardial infarction.

Surgical considerations in the treatment of acute acquired ventricular septal defect

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