Survival after surgical repair of ischemic ventricular septal rupture.

Abstract

OBJECTIVES:

We reviewed our results and experience over a 14-year period to identify predictors of outcome following surgical repair of postinfarction ventricular septal rupture.

METHODS:

A retrospective review was carried over a 14-year period. All patients had surgical repair of a postinfarction ventricular septal rupture. Patient demographics, perioperative variables, and survival data were collected. Logistic regression identified independent predictors of 30-day mortality. Multivariate analysis determined the effects of independent risk factors on survival.

RESULTS:

Surgery for postinfarction ventricular septal rupture was carried out on 59 patients. The median age was 69 years, and 69% were male. In 54% of patients, the ventricular septal rupture was anterior, and 75% had concomitant coronary artery bypass grafting. Mortality was 39% at 30 days. Age was the most important predictor of 30-day and long-term outcome. Logistic regression analysis identified age, preoperative ventilation, and female sex as significant predictors of 30-day mortality. Cardiogenic shock, preoperative ventilation, and advanced age were associated with reduced medium-term survival. Surprisingly, anterior ventricular septal rupture was associated with reduced long-term survival. Concomitant coronary artery bypass grafting did not influence 30-day or long-term outcome.

CONCLUSIONS:

Despite advances, the surgical mortality from ventricular septal rupture remains high. Age remains the most important predictor of outcome, and concomitant coronary artery bypass grafting does not appear to have a demonstrable benefit. Interestingly, anterior ventricular septal rupture had poorer long-term outcome than inferior ventricular septal rupture.

• Authors: Yasir Abu-Omar, Peter Bhinda, Cliff K C Choong, Samer A M Nashef, Sukumaran Nair
• Journal: Asian cardiovascular & thoracic annals (Asian Cardiovasc Thorac Ann) Vol. 20 Issue 4 Pg. 404-8 (Aug 2012) ISSN: 1816-5370 [Electronic] England
• PMID: 22879546 (Publication Type: Journal Article)

Topics

• Aged
• Female
• Humans
• Male
• Middle Aged
• Myocardial Infarction (complications)
• Myocardial Ischemia (complications)
• Retrospective Studies
• Survival Rate
• Ventricular Septal Rupture (etiology, mortality, surgery)