Decision Making, Management, and Midterm Outcomes of Postinfarction Ventricular Septal Rupture: Our Experience with 21 Patients

被引:4
作者
Bisoyi, Samarjit [1 ]
Jagannathan, Usha [1 ]
Dash, Anjan K. [1 ]
Mohapatra, Raghunath [2 ]
Nayak, Debashish [2 ]
Sahu, Satyajit [2 ]
Satyanarayan, Pattnaik [3 ]
机构
[1] Apollo Hosp, Dept Cardiac Anesthesiol, Sainik Sch Rd Plot 251, Bhubaneswar 751005, Odisha, India
[2] Apollo Hosp, Dept Cardiothorac & Vasc Surg, Bhubaneswar, India
[3] Talla Padmavathi Coll Pharm, Dept Pharm, Warangal, Telangana, India
关键词
Cardiac surgery; myocardial infarction; ventricular septal rupture; ACUTE MYOCARDIAL-INFARCTION; RISK-FACTORS; SURGICAL REPAIR; CARDIAC RUPTURE; HOSPITAL DEATH; DEFECT; PATTERNS; SURGERY;
D O I
10.4103/aca.ACA_119_19
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Context: Ventricular septal rupture (VSR) is a dreaded complication following myocardial infarction. Surgical repair of VSR is associated with significant early mortality. Variable outcomes in terms of early mortality and midterm functional status have been reported from different centers. Aims: In our study, we attempt to review the experience of decision making and surgical repair of postinfarction VSR, and to analyze the factors contributing to the early mortality and midterm outcome after repair. Materials and Methods: It is a retrospective study. Data were summarized retrospectively by frequencies and percentages for categorical factors, and means and standard deviations for continuous factors. Multivariate logistic regression, odds ratios, 95% confidence intervals, and P value were calculated for different variables to determine their independent effect on operative mortality. All surviving patients answered the EQ-5D Health Questionnaire. Results: Preoperative renal failure, left ventricular dysfunction (moderate and severe), and Killip class (III and IV) were significantly associated with early mortality after surgery. Small residual ventricular septal defect (VSD) was not found to affect the midterm quality of life. Conclusions: Early surgical repair benefits the patient by preventing early end-organ damage. The renal failure left ventricular dysfunction (moderate and severe) and Killip class (III and IV) adversely affect early outcomes after surgery. Small residual ventricular septal defect (VSD) does not affect the midterm quality of life.
引用
收藏
页码:472 / 477
页数:6
相关论文
共 30 条
[1]   TECHNICAL IMPROVEMENTS IN THE REPAIR OF ACUTE POSTINFARCTION VENTRICULAR SEPTAL RUPTURE [J].
ALVAREZ, JM ;
BRADY, PW ;
ROSS, DE .
JOURNAL OF CARDIAC SURGERY, 1992, 7 (03) :198-202
[2]   CARDIAC RUPTURE ASSOCIATED WITH THROMBOLYTIC THERAPY - IMPACT OF TIME TO TREATMENT IN THE LATE ASSESSMENT OF THROMBOLYTIC EFFICACY (LATE) STUDY [J].
BECKER, RC ;
CHARLESWORTH, A ;
WILCOX, RG ;
HAMPTON, J ;
SKENE, A ;
GORE, JM ;
TOPOL, EJ .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1995, 25 (05) :1063-1068
[3]   A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction [J].
Becker, RC ;
Gore, JM ;
Lambrew, C ;
Weaver, WD ;
Rubison, RM ;
French, WJ ;
Tiefenbrunn, AJ ;
Bowlby, LJ ;
Rogers, WJ .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1996, 27 (06) :1321-1326
[4]  
BRUNN F, 1923, WIEN ARCH INN MED, V6, P533
[5]  
COOLEY DA, 1957, SURGERY, V41, P930
[6]   Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction [J].
Crenshaw, BS ;
Granger, CB ;
Birnbaum, Y ;
Pieper, KS ;
Morris, DC ;
Kleiman, NS ;
Vahanian, A ;
Califf, RM ;
Topol, EJ .
CIRCULATION, 2000, 101 (01) :27-32
[7]   SURGERY FOR POST-MYOCARDIAL INFARCT VENTRICULAR SEPTAL-DEFECT [J].
DAGGETT, WM ;
GUYTON, RA ;
MUNDTH, ED ;
BUCKLEY, MJ ;
MCENANY, MT ;
GOLD, HK ;
LEINBACH, RC ;
AUSTEN, WG .
ANNALS OF SURGERY, 1977, 186 (03) :260-271
[8]  
Dalrymple-Hay M J, 1998, Semin Thorac Cardiovasc Surg, V10, P111
[9]  
David T E, 1998, Semin Thorac Cardiovasc Surg, V10, P105
[10]   POSTINFARCTION VENTRICULAR SEPTAL RUPTURE - REPAIR BY ENDOCARDIAL PATCH WITH INFARCT EXCLUSION [J].
DAVID, TE ;
DALE, L ;
SUN, Z .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1995, 110 (05) :1315-1322