Key result
Transcatheter closure in post-infarction ventricular septal rupture resulted in a thirty-day mortality rate of 65% compared to 88% in patients with cardiogenic shock.
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In patients with post-infarction ventricular septal rupture, aggressive hemodynamic stabilization and closure are critical, with ECMO serving as a potential bridge to delayed surgery in unstable patients.
Ventricular septal rupture is a potentially fatal complication of acute myocardial infarction. The key to management of this critical condition is an aggressive approach to haemodynamic stabilization and surgical closure of the rupture. Where there is a small rupture and the patient is in a haemodynamically stable condition, surgery can be delayed with the prospect of achieving better perioperative results. However, in unstable critically ill patients either immediate surgery or extracorporeal membranous oxygenation support and delayed surgery is indicated. In some patients, trans-catheter closure may be considered as an alternative to surgery.
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Novák et al. (2015) conducted a null in Ventricular Septal Rupture. transcatheter closure vs. surgical closure was evaluated on mortality rate (HR null, 95% CI null, p=null). Transcatheter closure in post-infarction ventricular septal rupture resulted in a thirty-day mortality rate of 65% compared to 88% in patients with cardiogenic shock.
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