Surgical Repair of Ventricular Septal Defect after Myocardial Infarction: A Single Center Experience during 22 Years
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 433-438, 2013.
Article
in English
| WPRIM
| ID: wpr-13275
ABSTRACT
BACKGROUND:
Surgical repair of post-infarct ventricular septal defect (VSD) is considered one of the most challenging procedures having high surgical mortality. This study aimed to evaluate the outcomes of the surgical repair of post-infarct VSD.METHODS:
From May 1991 to July 2012, 34 patients (mean age, 67.1+/-7.9 years) underwent surgical repair of post-infarct VSD. A retrospective review of clinical and surgical data was performed.RESULTS:
VSD repair involved the infarct exclusion technique using a patch in all patients. For coronary revascularization, 12 patients (35.3%) underwent concomitant coronary artery bypass graft, 3 patients (8.8%) underwent preoperative percutaneous coronary intervention, and 9 patients (26.5%) underwent both of these procedures. The early mortality rate was 20.6%. Six patients (17.6%) required reoperation due to residual shunt or newly developed VSD. During follow-up (median, 4.8 years; range, 0 to 18.4 years), late death occurred in nine patients. Overall, the 5-year and 10-year survival rates were 54.4%+/-8.8% and 44.3%+/-8.9%, respectively. According to a Cox regression analysis, preoperative cardiogenic shock (p=0.069) and prolonged cardiopulmonary bypass time (p=0.008) were independent predictors of mortality.CONCLUSION:
The early surgical outcome of post-infarct VSD was acceptable considering the high-risk nature of the disease. The long-term outcome, however, was still dismal, necessitating comprehensive optimal management through close follow-up.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Reoperation
/
Shock, Cardiogenic
/
Cardiopulmonary Bypass
/
Coronary Artery Bypass
/
Survival Rate
/
Retrospective Studies
/
Risk Factors
/
Follow-Up Studies
/
Mortality
/
Transplants
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2013
Type:
Article
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