Surgical repair of postinfarction ventricular septal rupture: Risk factors of early and late death

被引:43
作者
Lundblad, Runar [1 ]
Abdelnoor, Michel [2 ,3 ]
Geiran, Odd R. [1 ,4 ]
Svennevig, Jan L. [1 ,4 ]
机构
[1] Univ Oslo, Rikshosp, Dept Thorac & Cardiovasc Surg, N-0027 Oslo, Norway
[2] Ullevaal Univ Hosp, Unit Clin Epidemiol & Biostat, Oslo, Norway
[3] Ullevaal Univ Hosp, Unit Clin Epidemiol & Biostat, Oslo, Norway
[4] Univ Oslo, Rikshosp, Fac Div, N-0027 Oslo, Norway
关键词
ACUTE MYOCARDIAL-INFARCTION; HOSPITAL DEATH; DEFECT; SURGERY; REVASCULARIZATION; PATTERNS; PROFILE;
D O I
10.1016/j.jtcvs.2008.09.008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The aim of the study was to identify risk factors of early and late death after surgical repair of post-infarction ventricular septal rupture. Methods: During a 25-year period, from May 1981 to August 2006, 102 patients underwent repair of postinfarction ventricular septal rupture. Data were collected on clinical, angiographic, and echocardiographic findings; operative procedures; early morbidity; and survival time. Univariable and multivariable analyses were performed to identify risk factors of 30-day mortality and total mortality. Results: Thirty-day mortality was 33% altogether and decreased from 45% in the first half to 21% in the second half of the period ( P = .01). Follow- up was a mean of 5.2 +/- 6.2 years and a median of 2.9 years ( range, 0-26.3 years). Five- and 10-year cumulative survival was 50% and 32%, respectively. Shock at surgical intervention and incomplete coronary revascularization were strong and independent risk factors of both 30-day mortality and poor long-term survival. Conclusions: Early outcome after repair of ventricular septal rupture improved significantly during time, with 30-day mortality being 21% in the last decade. Five- and 10-year cumulative survival was 50% and 32%, respectively. Shock at surgical intervention and incomplete coronary revascularization were strong and independent predictors of poor early and late survival.
引用
收藏
页码:862 / 868
页数:7
相关论文
共 35 条
[1]  
ALTMAN DG, 1991, ANAL SURVIVAL TIMES, P365
[2]  
Anderson D R, 1989, Eur J Cardiothorac Surg, V3, P554, DOI 10.1016/1010-7940(89)90118-8
[3]   Repair of post-infarct ventricular septal defect with or without coronary artery bypass grafting in the northwest of England: a 5-year multi-institutional experience [J].
Barker, TA ;
Ramnarine, IR ;
Woo, EB ;
Grayson, AD ;
Au, J ;
Fabri, BM ;
Bridgewater, B ;
Grotte, GJ .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2003, 24 (06) :940-946
[4]   Current concepts - Ventricular septal rupture after acute myocardial infarction. [J].
Birnbaum, Y ;
Fishbein, MC ;
Blanche, C ;
Siegel, RJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (18) :1426-1432
[5]   Surgical treatment of ventricular septal defect complicating acute myocardial infarction. Experience of a north Italian referral hospital [J].
Cerin, G ;
Di Donato, M ;
Dimulescu, D ;
Montericcio, V ;
Menicanti, L ;
Frigiola, A ;
De Ambroggi, L .
CARDIOVASCULAR SURGERY, 2003, 11 (02) :149-154
[6]  
Cooley D A, 1998, Semin Thorac Cardiovasc Surg, V10, P100
[7]   Early mortality after surgical repair of postinfarction ventricular septal rupture: Importance of rupture location [J].
Cox, FF ;
Morshuis, WJ ;
Plokker, HWT ;
Kelder, JC ;
vanSwieten, HA ;
delaRiviere, AB ;
Knaepen, PJ ;
Vermeulen, FEE .
ANNALS OF THORACIC SURGERY, 1996, 61 (06) :1752-1757
[8]  
Cox FF, 1996, EUR HEART J, V17, P1841
[9]   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
[10]   QUANTITATIVE-ANALYSIS OF RIGHT AND LEFT-VENTRICULAR INFARCTION IN THE PRESENCE OF POSTINFARCTION VENTRICULAR SEPTAL-DEFECT [J].
CUMMINGS, RG ;
REIMER, KA ;
CALIFF, R ;
HACKEL, D ;
BOSWICK, J ;
LOWE, JE .
CIRCULATION, 1988, 77 (01) :33-42