The analysis of survival factors and hemodynamic assessment by echocardiography in perioperative patients with ventricular septal perforation after acute myocardial infarction

Abstract

Objective To follow up and analyze patients with ventricular septal rupture(VSR) after acute myocardial infarction (AMI) who underwent VSR occlusion, screen the main risk factors of survival in perioperative patients with VSR after AMI, and observe the postoperative cardiac function and hemodynamic changes by echocardiography. Methods Seventeen VSR patients were divided into the survival group (11 cases) and the death group (6 cases) within 30 days according to the survival time. The changes of cardiac ultrasound parameters before and after the operation of VSR survivors were compared, and the hemodynamic recovery characteristics of VSR survivors were analyzed. Results Age, the time to VSR occlusion, preoperative left ventricular ejection fraction, cardiogenic shock, and the size of VSR were all the factors that were closely related to the 30-day mortality of VSR with odds ratio of 0.90(95%CI 0.73 to 1.14, P=0.045), 1.89(95%CI 1.35 to 2.23, P=0.003), 0.89(95% CI 0.57 to 1.24, P=0.039), 1.45(95% CI 1.12 to 1.78, P=0.027) and 11.45(95%CI 7.89 to 15.56, P=0.012), respectively (all P<0.05). Compared with the preoperative measurements, the left ventricular end-diastolic volume and pulmonary artery systolic pressure were significantly reduced in the VSR survival group (P<0.05). Conclusions The decrease of left ventricular end diastolic volume and pulmonary artery systolic pressure after operation indicates a better prognosis in the short period. Echocardiography is a vital tool in preoperative screening, intraoperative monitoring and postoperative follow-up in VSR occlusion. Key words: Echocardiography; Ventricular septal rupture; Acute myocardial infarction