Why the study?
Does surgical repair improve clinical outcomes in patients with severe cardiac failure after postinfarctional ventricular septal rupture?
Does surgical repair improve clinical outcomes in patients with severe cardiac failure after postinfarctional ventricular septal rupture?
Surgical repair of postinfarctional ventricular septal rupture can yield significant clinical improvement in survivors, though the authors suggest postponing repair 2-3 months if the patient is not in unresponsive cardiogenic shock due to high initial mortality.
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Surgical repair may benefit select survivors of postinfarction VSR; leaves open optimal timing and selection for prospective study.
Three patients with severe cardiac failure after postinfarctional septal rupture were operated by cardio-pulmonary bypass 24 days, 5 months, and 2 1/2, years, respectively, after the infarction. Two of the defects were closed by direct suture, the third with a Dacron patch. Left ventricle aneurysmectomy was performed in 2 patients; in the third an infarcted akinetic area was resected. One patient died postoperatively, the other 2 were greatly improved and in good condition at follow-up 7 and 8 months after operation. The very high initial mortality indicates emergency closure in patients in non-responsive cardiac shock. If possible, surgical repair should be postponed 2–3 months.
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Skagseth et al. (1971) studied this question.
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