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>Journals >Cirugía y Cirujanos >Year 2012, Issue 6


Espinosa-Ledesma A, Ramírez-Orozco F, Herrera-Camacho G, Macías-Amezcua MD, González-Ojeda A, Fuentes-Orozco C
Mortality of interventricular septum rupture after acute myocardial infarction with surgical management
Cir Cir 2012; 80 (6)

Language: Español
References: 45
Page: 496-503
PDF: 218.80 Kb.

[Full text - PDF]

ABSTRACT

Background: ventricular septal rupture is a rare complication of myocardial infarction. It is considered the most serious mechanical disturbance in these cases. The mortality of patients during the hospital period receiving surgical treatment for this complication is described.
Methods: a case series study, including patients with ventricular septal rupture posterior to myocardial infarction, detected with a retrospective review of records of patients subjected to surgical repair from December 2005 to December 2010.
Results: a total of 20 patients were included, with an average age of 56 years (48-65 years), male gender in 16 cases (80%), and a male: female relation of 4:1. Ten (50%) of the patients died; five due to multiple organ failure, one from nosocomial pneumonia, two from ventricular fibrillation, and two from refractory shock secondary to biventricular failure during the surgery. The factors identified for poor prognosis were the average time of 145 minutes on cardiopulmonary bypass, and acute kidney injury in six cases, requiring replacement therapy.
Conclusions: ventricular septal rupture is a rare complication with a high mortality. Without surgical treatment mortality can reach almost 100%. The mortality of this pathology treated with surgical closing in our hospital was 50%, similar to other published reports. Our findings confirm that although surgery for ventricular septal rupture has a high mortality it should be carried out because it is a surgical emergency.


Key words: mortality, ventricular septal rupture, surgical management.


REFERENCES

  1. Daggett WM. Postinfarction ventricular septal defect repair: Retrospective thoughts and historical perspectives. Ann Thorac Surg 1990;50(6):1006-1009.

  2. Davies RH, Dawkins KD, Skillington PD, Lewington V, Monro JL, Lamb RK, et al. Late functional results after surgical closure of acquired ventricular septal defect. J Thorac Cardiovasc Surg 1993;106(4):592-598.

  3. Cooley DA, Belmonte BA, Zeis LB, Schnur S. Surgical repair of rupture of ruptured interventricular septum following acute myocardial infarction. Surgery 1957;41(6):930-937.

  4. León-Hernández G, Oropeza-Martínez G. Ruptura septal ventricular y aneurisma ventricular izquierdo posinfarto. Cir Ciruj 1999;67(2):70- 72.

  5. David TE, Dale L, Sun Z. Postinfarction ventricular septal rupture: Repair by endocardial patch with infarct exclusion. J Thorac Cardiovasc Surg 1995;110(5):1315-1322.

  6. Deville C, Fontan F, Chevalier JM, Madonna F, Ebner A, Besse P. Surgery of post-infarction ventricular defect: Risk factors for hospital death and long-term results. Eur J Cardiothorac Surg 1991;5(4):167- 174.

  7. David TE. Surgery for postinfarction ventricular septal defects. In David TE, editor. Mechanical Complications of Myocardial Infarction. Texas: RG Landes, 1993 p. 175-191.

  8. Rojas-Velasco G, Lerma C, Arias-Mendoza A, Álvarez-Sangabriel A, Altamirano A, Azar-Manzur F, et al. Características clínicas, modalidades de tratamiento y mortalidad en la rupture del septum interventricular posinfarto. Arch Cardiol Mex 2011;81(3):197-203.

  9. Fortin DF, Sheikh KH, Kisslo J. The utility of echocardiography in the diagnostic strategy of postinfarction ventricular septal rupture: A comparison of two-dimensional versus Doppler color flow imaging. Am Heart J 1991;121(1):25-32.

  10. Samuels LE, Entwistle JC 3rd, Holmes EC, Parris T, Welchesler AS. Mechanical support of the unrepaired postinfarction ventricular septal defect with the Abiomed BVS 5000 ventricular assist device. J Thorac Cardiovasc Surg 2003;126(6):2100-2101.

  11. Fujimoto K, Kawahito K, Yamaguchi A, Sakuragawa H, Tsuboi J, Yuri K, et al. Percutaneous Extracorporeal Life Support for Treatment of Fatal Mechanical Complications Associated with Acute Myocardial Infarction. Artif Organs 2001;25(12):1000-1003.

  12. Ryan TJ, Antman EM, Brooks NH, Califf RM, Hillis LD, Hiratzka LF, et al. 1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol 1999;34(3):890-911.

  13. Lemery R, Smith HC, Giuliani ER, Gersh BJ. Prognosis in rupture of the ventricular septum after acute myocardial infarction and role of early surgical intervention. Am J Cardiol 1992;70(2):147-151.

  14. Lundblad R, Abdelnoor M, Geiran OR, Svennevig JL. Surgical repair of postinfarction ventricular septal rupture: Risk factors of early and late death. J Thorac Cardiovasc Surg 2009;137(4):862-868.

  15. ISIS-2. Collaborative group. Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival). Lancet 1988;13;2(8607):349-360.

  16. Honan MB, Harrell FE Jr, Reimer KA, Califf RM, Mark DB, Pryor DB, et al. Cardiac rupture, mortality and the timing of thrombolytic therapy: A meta-analysis. J Am Coll Cardiol 1990;16(2):359-367.

  17. Massel DR. How sound is the evidence that thrombolysis increases the risk of cardiac rupture? Br Heart J 1993;69(4):284-287.

  18. Crenshaw BS, Granger CB, Birnbaum Y, Pieper KS, Morris DC, Kleiman NS, et al. Risk Factors, Angiographic Patterns, and Outcomes in Patients With Ventricular Septal Defect Complicating Acute Myocardial Infarction. GUSTO-I (Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries) Trial Investigators. Circulation 2000;101(1):27-32.

  19. Nakamura F, Minamino T, Higashino Y, Ito H, Fujii K, Fujita T, et al. Cardiac free Wall ruptura in acute myocardial infarction: Ameliorative effect of coronary reperfusion. Clin Cardiol 1992;15:244-250.

  20. López Sendón J, Gurfinkel P, Lopez de Sa E, Agnelli G, Gore JM, Steg PG, et al. Factors related to heart ruptura in acute coronary syndromes in the global registry of acute coronary events. Eur Heart J 2010;31(12):1449-1456.

  21. Noguchi K, Yamaguchi A, Naito K, Yuri K, Adachi H. Short-term and long-term outcomes of postinfarction ventricular septal perforation. Gen Thorac Cardiovasc Surg 2012;60(5):261-267.

  22. Arnaoutakis GJ, Zhao Yue, George TJ, Sciortino CM, McCarthy PM, Conte JV. Surgical Repair of Ventricular Septal Defect After Myocardial Infarction: Outcomes From The Society of Thoracic Surgeons National Database. Ann Thorac Surg 2012;94(2):436-444.

  23. Fukushima S, Tesar PJ, Jalali H, Clarke AJ, Sharma H, Choudhary J, et al. Determinants of in-hospital and long-term surgical outcomes after repair of postinfarction ventricular septal rupture. J Thorac Cardiovasc Surg 2010;140(1):59-65.

  24. Attia R, Blauth C. Which patients might be suitable for a septal occluder device closure of postinfarction ventricular septal rupture rather than immediate surgery? Interact Cardiovasc Thorac Surg 2010;11(5):626-629.

  25. Ito T, Hagiwara H, Maekawa A. Early and late results of entire septal patch technique for post infarction ventricular septal rupture. Gen Thorac Cardiovasc Surg 2012;60(8):475-479.

  26. Komeda M, Fremes SE, David TE. Surgical Repair of Postinfarction Ventricular Septal Defect. Circulation1990;82(5 Suppl):243-247.

  27. Kawai J, Yoshikawa J, Yoshida K, Hozumi T, Akasaka T, Syakudo M, et al. Pseudoaneurysm and ventricular septal rupture complicated with inferior myocardial infarction diagnosed by two-dimensional and Doppler echocardiography: case report. J Cardiol 1996;27(2):77- 83.

  28. Robicsek F. Surgical repair of extensive myocardial infarction: ventricular aneurysmectomy according to Dor with exclusionclosure of ventricular septal perforation and mitral replacement: a case report. J Heart Valve Dis 1996;5(5):561-563.

  29. Michel-Behnke I, Le TP, Waldecker B, Akintuerk H, Valeske K, Schranz D. Percutaneous Closure of Congenital and Acquired Ventricular Septal Defects — Considerations on Selection of the Occlusion Device. J Interv Cardiol 2005;18(2):89-99.

  30. Maree AO, Jneid H, Palacios IE. Percutaneous closure of a postinfarction ventricular septal defect that recurred after surgical repair. Eur Heart J 2006;27(13):1626.

  31. Hutchins KD, Skurnick J, Lavenhar M, Natarajan GA. Cardiac Rupture in Acute Myocardial Infarction: A Reassessment. Am J Forensic Med Pathol 2002;23(1):78-82.

  32. Lachapelle K, deVarennes B, Ergina PL, Cecere R. Sutureless patch technique for postinfarction left ventricular rupture. Ann Thorac Surg 2002;74(1):96-101.

  33. Tanaka K, Sato N, Yasutake M, Takeda S, Takano T, Ochi M, et al. Clinicopathological Characteristics of 10 Patients with Rupture of Both Ventricular Free Wall and Septum (Double Rupture) After Acute Myocardial Infarction. J Nihon Med Sch 2003;70(1):21-27.

  34. Jeppsson A, Liden H, Johnson P, Hartford M, Rådegran K. Surgical repair of post infarction ventricular septal defects: a national experience. Eur J Cardiothorac Surg 2005;27(2):216-221.

  35. Mantovani V, Mariscalco G, Leva C, Blanzola C, Sala A. Surgical repair of post-infarction ventricular septal defect: 19 years of experience. Int J Cardiol 2005;108(2):202-206.

  36. Barker TA, Ramnarine IR, Woo EB, Grayson AD, Au J, Fabri BM, et al. Repair of post-infarct ventricular septal defect with or without coronary artery bypass grafting in the northwest of England: a 5-year multi-institutional experience. Eur J Cardiothorac Surg 2003;24(6):940-946.

  37. Labrousse L, Choukroun E, Chevalier JM, Madonna F, Robertie F, Merlico F, et al. Surgery for post infarction ventricular septal defect VSD: Risk factors for hospital death and long term results. Eur J Cardiothorac Surg 2002;21(4):725-732.

  38. Rhydwen GR, Charman S, Schofield PM. Influence of thrombolytic therapy on the patterns of ventricular septal rupture of acute myocardial infarction. Postgrad Med J 2002;78(921):408-412.

  39. Hirata N, Sakai K, Sakaki S, Ohtani M, Nakano S, Matsuda H. Assessment of perioperative predictive factors influencing survival in patients with postinfarction ventricular septal perforation. Classified by the site of myocardial infarction. J Cardiovasc Surg 2000;41(4):547-552.

  40. Athanassiadi K, Apostolakis E, Kalavrouziotis G, Charitos C, Karamichali E, Kakavos D, et al. Surgical Repair of Postinfarction Ventricular Septal Defect: 10-Year Experience. World J Surg 1999;23(1):64-67.

  41. Blazquez J, Cortina J, Centeno J, Lopez M, Forteza A, Perez E, et al. Corrección quirúrgica de la comunicación interventricular post infarto: Factores predictores de mortalidad hospitalaria y supervivencia a largo plazo. Cir Cardiov 2009;16(2):197-205.

  42. Papadopulos N, Moritz A, Dzemali O, Zierer A, Rouhollapour A, Ackerman H, et al. Long-Term Results After Surgical Repair of Postinfarction Ventricular Septal Rupture by Infarct Exclusion Technique. Ann Thorac Surg 2009;87(5):1421-1425.

  43. Vargas-Barrón J. Postinfarction intramyocardial dissection. Arch Cardiol Mex 2007;77(Suppl 4):152-156.

  44. Moreyra AE, Huang MS, Wilson AC, Deng Y, Cosgrove NM, Kostis JB, et al. Trends in Incidence and Mortality Rates of Ventricular Septal Rupture During Acute Myocardial infarction. Am J Cardiol 2010;106(8):1095-1100.

  45. Iino T, Watanabe H, Yoshida M, Ito H. An unusual interventricular communication after acute myocardial infarction. Eur Heart J 2012;33(8):937.






>Journals >Cirugía y Cirujanos >Year 2012, Issue 6
 

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