Why the study?
Post-infarction ventricular septal defect carries high mortality, and retrospective comparisons between surgical repair and percutaneous closure are limited by observation and selection bias.
Does percutaneous transcatheter closure improve outcomes compared to surgical intervention or medical management in patients with post-infarction ventricular septal defect?
Does percutaneous transcatheter closure improve outcomes compared to surgical intervention or medical management in patients with post-infarction ventricular septal defect?
Percutaneous transcatheter closure is a viable alternative to surgical repair for post-infarction ventricular septal defect, though both interventions still carry a high in-hospital mortality of over 40%.
Mortality remains high with current strategies; leaves open optimal closure timing and method in post-MI VSD.
Post-infarction ventricular septal defect is a mechanical complication of acute MI. The incidence of this complication is low in the primary percutaneous coronary intervention era. However, the associated mortality is very high at 94% with medical management alone. Open surgical repair or percutaneous transcatheter closure still has an in-hospital mortality >40%. Retrospective comparisons between both closure methods are limited by observation and selection bias. This review addresses the assessment and optimisation of patients prior to repair, the optimal timing of repair, and the limitations in current data. The review considers techniques for percutaneous closure, and finally considers the path that future research should take to improve outcomes for patients.
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Cadogan et al. (2023) studied this question.
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