Ventricular Septal Rupture as a Complication of Acute Myocardial Infarction: Clinical Characteristics and Prognostic Comparison of Different Treatment Methods

BACKGROUND: This research aimed to investigate the clinical features exhibited by individuals diagnosed with acute myocardial infarction (AMI) complicated by ventricular septal rupture (VSR) and to compare the prognostic outcomes of different treatment modalities. METHODS: A retrospective study on a cohort of 200 patients who were diagnosed with AMI complicated by VSR at a specialized medical facility from 2018 to 2023 was conducted. The patients were categorized into 3 different treatment groups: group A received medical management, group B underwent surgical repair, and group C underwent percutaneous device closure. Our primary objective was to assess the overall mortality rate within 1 year, while secondary objectives included evaluating in-hospital mortality, mortality within 30 days, and occurrence of major adverse cardiovascular events within 1 year. RESULTS: Group A showed the highest in-hospital mortality rate of 37.3%. The rate for group B was only 20.6%, while group C exhibited the lowest rate of 17.4%. A similar tendency was observed for the 30-day and 1-year mortality rates. The 30-day mortality rate for group A, group B, and group C was 56.9%, 20.6%, and 22.1%, respectively. The 1-year mortality rate for group A, group B, and group C was as follows: 31.4%, 28.6%, and 25.6%. In addition, the incidence of major adverse cardiovascular events at 1 year was highest in group A (56.9%), followed by group B (28.6%) and group C (32.6%). CONCLUSION: Both surgical repair and percutaneous device closure were associated with significantly better survival outcomes compared to medical management alone in patients with AMI complicated by VSR.