Interventional post-myocardial infarction ventricular septal defect closure: a systematic review of current evidence
Key result
Percutaneous closure of post-MI VSDs achieves high success but early mortality remains ~32%.
- n=273
Why the study?
What are the success rates and clinical outcomes of percutaneous device closure for post-myocardial infarction ventricular septal defects?
Population
273 patients with post-myocardial infarction ventricular septal defects pooled from 13 patient series. Mean…
Design
Systematic_review
Follow-up
in-hospital/30-day
Authors
Discussion
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Implication
High implantation success supports percutaneous post-MI VSD closure feasibility; leaves open optimal selection and timing to lower mortality.
Study Design
Type
Systematic Review (n=273)
Multicenter
Yes
Structured PICO
What are the success rates and clinical outcomes of percutaneous device closure for post-myocardial infarction ventricular septal defects?
P
Population
273 patients with post-myocardial infarction ventricular septal defects (VSD) pooled from 13 patient series. Mean age 70 years, 48% in cardiogenic shock at the time of intervention.
I
Intervention
Percutaneous device closure of post-infarction VSD
O
Outcome
Success rate (technical success, successful device implantation) and clinical outcome (in-hospital/30-day mortality)hard clinical
Percutaneous device closure of post-MI VSD has a high technical success rate (89%) but is associated with high 30-day mortality (32%), particularly in patients presenting with cardiogenic shock.
Limitations
- Underlying data lack a control group and are non-randomised
- Inherent selection bias with all case series
- Direct comparison between surgical and interventional closure is not possible
- Sub-analysis according to the type of septal defect occluder was not possible
Cite This Study
Schlotter et al. (2016) conducted a systematic review in Post-myocardial infarction ventricular septal defect (n=273). Percutaneous device closure was evaluated on In-hospital or 30-day mortality. Percutaneous device closure of post-myocardial infarction ventricular septal defects achieved an 89% successful implantation rate, but overall in-hospital or 30-day mortality remained high at 31.5%.