Key result
Percutaneous closure of post-myocardial infarction ventricular septal rupture resulted in an overall mortality rate of 37.7%, with higher mortality observed in patients treated in the acute phase or presenting with cardiogenic shock.
Why the study?
Does percutaneous occlusion provide a feasible and safe treatment for post-myocardial infarction ventricular septum rupture?
Systematic Review (n=176)
Does percutaneous occlusion provide a feasible and safe treatment for post-myocardial infarction ventricular septum rupture?
Percutaneous closure of post-infarction VSR is a feasible alternative to surgery, with better survival when deferred to the chronic phase (≥14 days) and in patients without cardiogenic shock.
Supports selective percutaneous post-MI VSR closure in stable patients; extends systematic evidence favoring deferral beyond the acute phase.
AIMS: The aim of this systematic review is to gain insight into the published experience on percutaneous closure of a post-infarction ventricular septal rupture (VSR). METHOD: Relevant literature was obtained by MeSH-term searches in the online search-engine PubMed. Articles published in the last 10 years were included. Further filtering was done by using search limits and individual article selection based on the aims of this systematic review. CONCLUSION: Percutaneous closure is a potential technique in a select group of patients. The presence of cardiogenic shock and closure in the acute phase after VSR diagnosis are important risk factors of mortality. Device implantation is in general successful with few procedure-related complications. Reduction of the shunt fraction has been reported frequently. This technique is a less invasive alternative to surgical treatment and should be applied on a case-by-case basis.
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Risseeuw et al. (2013) conducted a systematic review in Post-myocardial infarction ventricular septum rupture (n=176). Percutaneous occlusion was evaluated on Overall mortality. Percutaneous closure of post-myocardial infarction ventricular septal rupture resulted in an overall mortality rate of 37.7%, with higher mortality observed in patients treated in the acute phase or presenting with cardiogenic shock.
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