Surgical treatment of postinfarction ventricular septal rupture

Mustafa Bahadır İnan

doi:10.5606/tgkdc.dergisi.2011.004

Abstract

Surgical treatment of postinfarction ventricular septal rupture

Highlights

Due to the introduction and continuous improvement of early percutaneous revascularization strategies, its incidence has decreased to about 0,25% of acute myocardial infarction (AMI) cases.[3,4,5,6]
In accordance with other reports, our study showed that the postoperative need of intra-aortic balloon pump (IABP) or extracorporeal membrane oxygenation (ECMO) supports represented independent predictors of mortality, probably because they were reserved only as last-resort for more compromised patients.[1,16]
Post-infarction Ventricular septal rupture (VSR) remains a severe condition with a challenging management in all its phases, from preoperative to perioperative periods

Summary

Introduction

Ventricular septal rupture (VSR) is a rare, but life-threatening mechanical complication of acute myocardial infarction (AMI).[1,2] Due to the introduction and continuous improvement of early percutaneous revascularization strategies, its incidence has decreased to about 0,25% of AMI cases.[3,4,5,6] if left untreated, it is almost inevitably fatal.[2]even when prompt surgery can be offered, in-hospital mortality remains very high and it didn’t change over the years, identifying VSR as the most lethal cardiac surgical condition.[1,3,6]Percutaneous closure devices and mechanical circulatory supports (MCS) may offer alternative or synergistic strategies to treat these patients, both pre- and postoperatively.[7,8]surgery remains the gold-standard for post-infarction VSR. Ventricular septal rupture (VSR) is a rare, but life-threatening mechanical complication of acute myocardial infarction (AMI).[1,2] Due to the introduction and continuous improvement of early percutaneous revascularization strategies, its incidence has decreased to about 0,25% of AMI cases.[3,4,5,6] if left untreated, it is almost inevitably fatal.[2]. Even when prompt surgery can be offered, in-hospital mortality remains very high and it didn’t change over the years, identifying VSR as the most lethal cardiac surgical condition.[1,3,6]. Percutaneous closure devices and mechanical circulatory supports (MCS) may offer alternative or synergistic strategies to treat these patients, both pre- and postoperatively.[7,8]. Repair is generally recommended and is often demanded due to the presence of hemodynamic instability, but clear indications on ideal management and timing of intervention have not yet been well established.[3,6,9,10] given the low incidence of this condition, most reports consist of single-center experiences with limited patient cohorts, or of national registries.1,11–

Methods

Results

Discussion

Conclusion