Post-Infarction Ventricular Septal Rupture: 10 Years of Experience / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery
; : 351-355, 2007.
Article
in Korean
| WPRIM (Western Pacific)
| ID: wpr-117365
Responsible library:
WPRO
ABSTRACT
BACKGROUND:
Postinfarction ventricular septal rupture is associated with mortality as high as 85~90%, if it is treated medically. This report documents our experience with postinfarction ventricular septal rupture that was treated surgically. MATERIAL ANDMETHOD:
We retrospectively reviewed the medical records of 11 patients who were operated on due to postinfarction ventricular septal rupture between August 1996 and August 2006. There were 4 men and 7 women, with a mean age of 70+/-11 years (age range 50~84 years). The location of the rupture was anterior in 7 cases and posterior in 4 cases. The interval between the onset of acute myocardial infarction and the occurrence of the ventricular septal rupture was 2.0+/-1.3 days (range 1~5 days). Operation was performed at an average of 2.4+/-2.7 days (range 0~8 days) after the diagnosis of septal rupture. Preoperative intraaortic balloon pump therapy was performed in 10 patients.RESULT:
The infarct exclusion technique was used in all cases. Coronary artery bypass grafting was done in 8 cases, with the mean number of distal anastomosis being 1.0+/-0.8. There was one operative death. In 2 patients, reoperation was performed due to a residual septal defect. The postoperative morbidities were transient atrial fibrillation (n=7), paroxysmal supraventricular tachycardia (n=1), low cardiac output syndrome (n=3), bleeding reoperation (n=2), delayed sternal closure (n=2), acute renal failure (n=2), pneumonia (n=1), intraaortic balloon pump-related thromboembolism (n=1), and transient delirium (n=2). Nine patients have been followed up for a mean of 38+/-40 months except for one follow-up loss. There have been 3 late deaths. At the latest follow-up, all 6 survivors were in a good functional class.CONCLUSION:
We demonstrated satisfactory operative and midterm results with our strategy of preoperative intraaortic balloon pump therapy, early repair of septal rupture by infarct exclusion and combined coronary revascularization.
Full text:
Available
Health context:
SDG3 - Health and Well-Being
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SDG3 - Target 3.3 End transmission of communicable diseases
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SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Target 3.4: Reduce premature mortality due to noncommunicable diseases
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Pneumonia
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Cardiovascular Disease
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Ischemic Heart Disease
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Mental Health and Behavioral Disorders
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Other Respiratory Diseases
Database:
WPRIM (Western Pacific)
Main subject:
Pneumonia
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Reoperation
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Rupture
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Atrial Fibrillation
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Thromboembolism
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Tachycardia, Supraventricular
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Cardiac Output, Low
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Medical Records
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Coronary Artery Bypass
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Retrospective Studies
Type of study:
Diagnostic study
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Observational study
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Prognostic study
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Risk factors
Limits:
Female
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Humans
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Male
Language:
Korean
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2007
Document type:
Article