Ventricular septal rupture complicating acute myocardial infarction: clinical characteristics and contemporary outcome

Ann Thorac Surg. 2008 May;85(5):1591-6. doi: 10.1016/j.athoracsur.2008.01.010.

Abstract

Background: The objective of this paper was to study the patient characteristics and contemporary short- and long-term outcome in patients with postinfarct ventricular septal rupture.

Methods: Based on patient files and register data we performed a review of 64 consecutive patients with ventricular septal rupture complicating acute myocardial infarction, admitted to our tertiary center.

Results: The mean age of the patients was 70 +/- 7. The median time was five days from onset of symptoms to the diagnosis of the ventricular septal rupture. The overall 30-day, one-, and five- year mortalities were 62%, 72%, and 95%, respectively. Medical treated patients (n = 19) had a 30-day mortality of 100%. Among surgically treated patients (n = 45) the survival at one month, one and five years was 71%, 48%, and 32%, respectively. History of hypertension, complicating congestive heart failure, and age were associated with poor outcome.

Conclusions: Despite improvements in medical and interventional techniques the early as well as the long-term prognosis remains poor in this contemporary series.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Coronary Angiography
  • Echocardiography
  • Female
  • Heart Rupture, Post-Infarction / diagnosis
  • Heart Rupture, Post-Infarction / mortality
  • Heart Rupture, Post-Infarction / surgery*
  • Heart Septal Defects, Ventricular / diagnosis
  • Heart Septal Defects, Ventricular / mortality
  • Heart Septal Defects, Ventricular / surgery*
  • Heart Septum / surgery*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / mortality
  • Retrospective Studies
  • Survival Rate