Document Detail


Repair of post-infarct ventricular septal rupture with an infarct-exclusion technique: early results.
MedLine Citation:
PMID:  16844632     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ventricular septal rupture is a rare but life-threatening complication of acute myocardial infarction. The mortality rate with medical treatment is more than 90%, whereas the mortality rate after surgical repair varies between 19% and 60% in different studies. This study reviews our experience based on early closure of the septal rupture with an infarct-exclusion technique. METHODS: Eighteen consecutive patients who underwent post-infarct ventricular septal rupture operation between June 1, 2000, and November 1, 2005, were included in the study. There were 12 male and 6 female patients. Mean age was 65.72 +/- 5.21 years. All patients had echocardiography and coronary angiography before the operation. Rupture was closed with an infarct-exclusion technique in all patients. Preoperative, operative, and postoperative information were collected from patient cohorts. RESULTS: The median time from myocardial infarction to diagnosis of the ventricular septal rupture was 4.22 +/- 1.61 days. Fourteen of the patients had intra-aortic balloon pump support, and 5 had mechanic ventilator support preoperatively. Surgical repair was done 1 to 4 days after the diagnosis. Ten anterior and 8 posterior ventricular septal ruptures were found. Additional coronary artery bypass surgery was performed with a median of 1.27 +/- 0.8 grafts in 15 (83.3%) patients. The mean postoperative mechanic ventilator support time was 34.13 +/- 45.11 hours. Overall 30-day mortality was 16.7% with 3 patients. The mean intensive care unit stay was 3.3 +/- 1.6 days. Postoperative transthoracic echocardiography showed minimal residual shunts in 4 patients. CONCLUSION: Patch closure of the ventricular septal rupture with an infarct-exclusion technique provided acceptable results. Concomitant coronary artery bypass grafting might be beneficial to control additional risk of an associated coronary artery lesion. Prompt diagnosis followed by early surgical intervention is essential for patients with ventricular septal rupture.
Authors:
Banu Lafci; Necmettin Yakut; Tayfun Göktogan; Ibrahim Ozsöyler; Bilgin Emrecan; Haydar Yasa; Yüksel Besir; Ali Gürbüz
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  9     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2006  
Date Detail:
Created Date:  2006-07-17     Completed Date:  2006-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E737-40     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Atatürk Training and Research Hospital, Izmir, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiovascular Surgical Procedures / methods*
Female
Humans
Male
Myocardial Infarction / complications*,  surgery*
Pilot Projects
Treatment Outcome
Ventricular Septal Rupture / etiology*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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