Why the study?
Surgical approaches to post-myocardial infarction ventricular septal defect closure carry high morbidity and mortality, and the optimal timing of intervention remains controversial.
Does delayed surgical closure improve operative success compared to early intervention in patients with post myocardial infarction ventricular septal defect?
Does delayed surgical closure improve operative success compared to early intervention in patients with post myocardial infarction ventricular septal defect?
This case series reports on the outcomes of early versus delayed surgical closure for post-myocardial infarction ventricular septal defect.
Delayed PIVSD repair may benefit stabilized patients; leaves open optimal timing in larger prospective studies.
Introduction: Surgical approaches to closure of post myocardial infarction ventricular septal defect (PIVSD) are associated with high morbidity and mortality. Timing of intervention for its closure remains controversial. Several studies advocate early operative intervention, after diagnosis of PIVSD but these are associated with high mortality. However, the strategy of delayed closure around 14 to 20 days or higher has been advocated in certain subsets of patients who can be stabilized from cardiogenic shock (CS) with pharmacological means with or without temporary mechanical circulatory support (tMCS). This helps to allow tissue fibrosis around PIVSD which increases the chance of operative success. Results of 5 such patients in whom surgery was moderately delayed, and 2 in whom early operation were performed are reported in this paper.
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Dasbaksi et al. (2019) studied this question.
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