Key result
Surgical repair of postinfarction ventricular septal defect was associated with a 45% hospital mortality rate, with preoperative mechanical ventilation, postoperative renal replacement therapy, and residual defect identified as strong predictors of mortality.
Why the study?
The study was conducted to present clinical experience in treating post-myocardial infarction ventricular septal defect and examine associated risk factors.
What are the predictors of hospital mortality in patients undergoing urgent/emergency surgical repair of post-myocardial infarction ventricular septal defect?
Cohort (n=20)
No
What are the predictors of hospital mortality in patients undergoing urgent/emergency surgical repair of post-myocardial infarction ventricular septal defect?
Urgent/emergency surgical repair of post-infarction ventricular septal defect carries a 45% mortality rate, which is strongly predicted by preoperative mechanical ventilation, postoperative renal replacement therapy, and residual defect.
Preop ventilation, postop RRT, and residual defect flag high mortality after post-MI VSD repair; leaves open targeted strategies pending prospective validation.
BACKGROUND: The aim of this study was to present our experience in the treatment of post-myocardial infarction ventricular septal defect and examine the various risk factors. METHODS: This is a retrospective study. From January 2010 to December 2018, 20 patients underwent an urgent /emergency surgical repair of post-myocardial infarction ventricular septal defect. RESULTS: The mortality in our group of patients was 45 %. Non-survivors compared to the survivors were all in cardiogenic shock (p=0.0098), had an emergency/salvage operation (p=0.0055), preoperative mechanical ventilation (p=0.0081), shorter time between intraaortic balloon pressure insertion and surgery (p=0.0115), shorter median time between ventricular septal defect and surgery, postoperative renal replacement therapy (p=0.0498), and more patients had a residual effect (p=0.0022). In multivariate analysis, preoperative mechanical ventilation (p=0.0001), postoperative renal replacement therapy (p=0.0021) and residual defect (p=0.0000027) were shown to be strong predictors for hospital mortality. CONCLUSION: This analysis showed that post-myocardial infarction ventricular septal defect repair is a devastating complication and preoperative mechanical ventilation, postoperative renal replacement therapy and residual defect were identified to be the predictors of mortality. Initial stabilization of the patients, when it is possible, and a delayed repair, may improve the outcome of these patients (Tab. 3, Ref. 17).
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Artemiou et al. (2021) conducted a cohort in Post-myocardial infarction ventricular septal defect (n=20). Surgical repair of postinfarction ventricular septal defect was evaluated on Hospital mortality. Surgical repair of postinfarction ventricular septal defect was associated with a 45% hospital mortality rate, with preoperative mechanical ventilation, postoperative renal replacement therapy, and residual defect identified as strong predictors of mortality.
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