Surgical Repair of Post Infarction Ventricular Septal Rupture: An 18 Years' Retrospective Multicenter Study- Where there was no ECMO

authors:

avatar Mahmoud Beheshti 1 , avatar Zohre Mohammadi ORCID 1 , 2 , avatar Saman Rostambeigi ORCID 3 , avatar Parham Sadeghipour ORCID 3 , avatar Anahita Tavousi 4 , avatar Mahnoosh Foroughi ORCID 5 , *

Clinical Research and Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. #The first and second authors have contributed equally as the first author.
Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Cardiovascular research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
International Cardiovascular Research Journal: Vol.15, issue 2; e116606
published online: June 30, 2021
article type: Research Article
received: May 26, 2021
accepted: July 19, 2021

how to cite: Beheshti M, Mohammadi Z, Rostambeigi S, Sadeghipour P, Tavousi A, et al. Surgical Repair of Post Infarction Ventricular Septal Rupture: An 18 Years' Retrospective Multicenter Study- Where there was no ECMO. Int Cardiovasc Res J. 2021;15(2):e116606. 

Abstract

Background:
Ventricular Septal Rupture (VSR) is a rare but challenging complication after Myocardial Infarction (MI).
Objectives:
The present study aimed to evaluate the surgical outcomes of VSR over 18 years.
Methods:
This multicenter study was conducted on 88 patients with post-MI VSR during 2000 - 2018. 
Results:
A consecutive series of 88 patients with surgical repair of VSR was evaluated. The patients (n = 11) presenting hemodynamic deterioration at the time of hospital admission died before any attempt for surgery. The mean intervals between MI and VSR diagnosis and between admission and operation were 7.5 ± 7.2 and 5 ± 5 days, respectively. VSR location did not influence the outcomes (P = 0.1). Concomitant coronary bypass was done for all patients. Only 25 patients survived and left the hospital (13 patients died in the operating room due to pump weaning failure and 50 patients died in the ICU due to low cardiac output). The predictors of poor prognosis included low ejection fraction (P = 0.01), prolonged pump time (P = 0.01), and operation in the second half of the study period (P = 002). However, the results of multivariate analysis showed that none of them was an independent predictor of perioperative mortality.
Conclusions:
The perioperative mortality rate of VSR has remained high in case of inaccessibility to assist devices. Hence, VSR repair is recommended to be limited to certain centers with adequate experiences.
 

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Note: Zohre Mohammadi and Mahmoud Beheshti participated to the same extent in this study.

References

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