Analysis of clinical characteristics and prognosis of patients with acute myocardial infarction complicated with ventricular septal perforation and formation of ventricular aneurysm / 中国介入心脏病学杂志

ABSTRACT

Objective To investigate the clinical characteristics,treatment and prognosis of patients with acute myocardial infarction complicated with ventricular septal perforation and ventricular aneurysm formation. Methods The clinical data,treatment methods and prognosis of 11 patients, who admitted between January 2012 and December 2016 in Xinjiang Uygur Autonomous Region People 's Hospital,with acute myocardial infarction complicated with ventricular septal perforation and ventricular aneurysm were analyzed retrospectively. Results the killip grading of the 11 patients were Grade Ⅱ in 1 patients. Grade Ⅱ in 2 patients and Grade Ⅲ in 8 patients .The infarction site was found at the anterior wall in 3 patients,diffuse anterior well in 1 patients,inferior wall in 1 patient, anterior-inferior infarction in 3 patients and diffuse anterior-inferior infarction wall in 1 patient. Septal perforation was found at posterior septum in 5 patients muscular septum in. Patient and at apex in 5 patients. Septal perforation was identified within 24 hours of infarction in 1 patient,within 1-7 days in 3 patients and beyond 7 days after infarction in 7 patients .4 patients with septal perforation chosed conservative medical management only and 2 of them died 1 month later.2 patients had PCI in addition to medical treatment but both of them died in 3 months after discharge. 2 patients had IABP supper,and 1 of then died within 1 week during hospitalzation and the other one died 1 week after discharge. 2 patients received PCI and electric amplatzer closure(4-6 weeks after AMI,and 1 patient received PCI plus elective surgical septal repair and ventricular aneurysm reshaping at 6 months after AMI. All 3 patients survived during follow up. Conclusions For patients with acute myocardial infarction complicated with ventricular septal perforation and ventricular aneurysm formation,aggressive intervention and treatment will improve the clinical prognosis.