Optimum time and management for postmyocardial infarction ventricular septal rupture: A systematic review and meta-analysis

Background: Ventricular septal rupture (VSR) is one of the most fatal complications following myocardial infarction with high morbidity and mortality. Usually, the incidence of VSR ranges between 1% to 3% with some studies suggested it was declined to 0.3% with PCI era. Objective: To systemically assess the evidence regarding the optimum time and management for postmyocardial infarction ventricular septal rupture. Patients and Methods: The Cochrane Handbook for Systematic Reviews of Interventions was followed in the preparation of this systematic review. Additionally, we followed the Preferred Reporting Items for Systematic reviews and Meta- Analyses (PRISMA) criteria. Results: According to our findings, there was no significant difference in the cardiogenic shock risk ratio between patients who underwent early and late correction for ventricular septal defects after myocardial infarction. Our findings demonstrated that there was no significant difference ( P=0.57 ) in the time of VSD from MI standard mean difference between early and late correction for ventricular septal defect following myocardial infarction. There was no significant difference in the requirement for the IABP risk ratio between patients who underwent early and late repair for ventricular septal defects following myocardial infarction. The CPB time standard mean difference between early and late correction for ventricular septal defect, postmyocardial infarction patients significantly differ. Conclusion: Based on these findings, it can be concluded that shorter time from MI to surgery and from admission to surgery were associated with higher mortality.