Why the study?
Post-myocardial infarction ventricular septal rupture is a rare but fatal mechanical complication frequently complicated by cardiogenic shock.
Does transcatheter device closure improve survival in surgically declined patients with post-myocardial infarction ventricular septal rupture?
Does transcatheter device closure improve survival in surgically declined patients with post-myocardial infarction ventricular septal rupture?
Transcatheter device closure for post-MI VSR in surgically declined patients achieves high technical success, but 30-day mortality remains high and is strongly driven by baseline physiological status and shock severity.
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High technical success but substantial early mortality with transcatheter closure in post-MI VSR; leaves open its role in cardiogenic shock.
Post-myocardial infarction ventricular septal rupture is a rare but fatal mechanical complication, frequently complicated by cardiogenic shock. We conducted a single-centre retrospective cohort study of seventeen surgically declined patients who underwent transcatheter device closure between 2014 and 2025. Cardiogenic shock was present in 15 of 17 patients (88.2%). Device implantation achieved high technical success; however, early mortality remained substantial, with only six patients (35.3%) surviving beyond 30 days. Deaths were mainly due to refractory shock and multiorgan failure. Survival was associated with lower SCAI shock stage, preserved lactate clearance, and higher arterial pH, underscoring the importance of physiological status.
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Chandra et al. (2026) studied this question.
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