Document Detail

Technical improvements in the repair of acute postinfarction ventricular septal rupture.
MedLine Citation:
PMID:  1392226     Owner:  NLM     Status:  MEDLINE    
Postinfarction ventricular septal rupture (VSR) is a high-risk complication following myocardial infarction (MI). Surgical treatment has evolved to improve an otherwise poor prognosis. Certain subsets of patients remain a formidable challenge. The presence of cardiogenic shock has consistently been found to have the highest risk. Over a 10-year period, our technique of repair has evolved from established procedures to one we believe confers superior results. Endocardial patching to viable myocardium reinforced with an epicardial patch not only corrects the shunt but maintains ventricular geometry and avoids tension on friable muscle. We report on a series of nine consecutive patients in cardiogenic shock. The operative mortality was 22%, none due to low cardiac output syndrome, shunt recurrence, or bleeding. All patients have been followed with transesophageal echocardiography at a mean period of 14 months (range 3-31 months). One patient is in New York Heart Association (NYHA) Class I, four are in NYHA Class II, and two in NYHA Class III.
J M Alvarez; P W Brady; D E Ross
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  7     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1992 Sep 
Date Detail:
Created Date:  1992-10-28     Completed Date:  1992-10-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  198-202     Citation Subset:  IM    
Department of Cardiothoracic Surgery, Royal North Shore Hospital, Sydney, Australia.
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MeSH Terms
Follow-Up Studies
Heart Rupture, Post-Infarction / complications,  mortality,  surgery*
Intraoperative Care / methods
Prostheses and Implants*
Risk Factors
Shock, Cardiogenic / etiology,  mortality*

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