HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Duncan A. Killen Jeffrey M. Piehler A. Michael Borkon Michael E. Gorton William A. Reed Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Killen, D. A. Articles by Reed, W. A. Search for Related Content PubMed PubMed Citation Articles by Killen, D. A. Articles by Reed, W. A.

Ann Thorac Surg 1997;63:138-142
© 1997 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Early Repair of Postinfarction Ventricular Septal Rupture

MidAmerica Heart Institute, Saint Luke's Hospital, and Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri

Accepted for publication July 22, 1996.

Background. Postinfarction rupture of the interventricular septum is usually fatal without surgical intervention. The optimal timing and the most appropriate technique of surgical repair remain unsettled.

Methods. The results of surgical closure of postinfarction ventricular septal defect in a consecutive series of patients seen over a 24-year period were reviewed and analyzed. Late follow-up was obtained in all patients who survived the operation.

Results. Sixty of 76 patients treated surgically exhibited cardiogenic shock, low cardiac output syndrome, or both at the time of operation. A plan of early operative intervention was followed in these unstable patients, with 60% of them undergoing repair within 24 hours of septal rupture. For the entire series of patients, the hospital mortality rate was 40.8%; survival was 41.5% at 5 years and 25.6% at 10 years postoperatively.

Conclusions. Significant trends observed during the period of study were a more aggressive stance regarding surgical intervention in all patients who presented with hemodynamic instability and improved survival in those patients who presented with septal rupture complicating an inferior myocardial infarction.

This article has been cited by other articles:

				A. K. Agnihotri, J. C. Madsen, and W. M. Daggett Jr Surgical Treatment of Complications of Acute Myocardial Infarction: Postinfarction Ventricular Septal Defect and Free Wall Rupture Card. Surg. Adult, January 1, 2008; 3(2008): 753 - 784. [Full Text]

				A. K. Agnihotri, J. C. Madsen, and W. M. Daggett Jr. Surgical Treatment of Complications of Acute Myocardial Infarction: Postinfarction Ventricular Septal Defect and Free Wall Rupture Card. Surg. Adult, January 1, 2003; 2(2003): 681 - 714. [Full Text]

				M. Ono, R. K. Wolf, D. Angouras, and E. W. Schneeberger Early experience of coronary artery bypass grafting with a new self-closing clip device J. Thorac. Cardiovasc. Surg., April 1, 2002; 123(4): 783 - 787. [Abstract] [Full Text] [PDF]

				C. J.M. Klijn, L. J. Kappelle, M. J. van Schooneveld, V. P.T. Hoppenreijs, A. Algra, C. A.F. Tulleken, and J. van Gijn Venous Stasis Retinopathy in Symptomatic Carotid Artery Occlusion: Prevalence, Cause, and Outcome Stroke, March 1, 2002; 33(3): 695 - 701. [Abstract] [Full Text] [PDF]

				T. lto, H. Hagiwara, and A. Maekawa Entire septal patch technique for postinfarction ventricular septal rupture Ann. Thorac. Surg., July 1, 2000; 70(1): 273 - 274. [Abstract] [Full Text] [PDF]

				M. Massetti, G. Babatasi, O. Le Page, S. Bhoyroo, E. Saloux, and A. Khayat POSTINFARCTION VENTRICULAR SEPTAL RUPTURE: EARLY REPAIR THROUGH THE RIGHT ATRIAL APPROACH J. Thorac. Cardiovasc. Surg., April 1, 2000; 119(4): 784 - 789. [Abstract] [Full Text] [PDF]

				S. M. Hollenberg, C. J. Kavinsky, and J. E. Parrillo Cardiogenic Shock Ann Intern Med, July 6, 1999; 131(1): 47 - 59. [Abstract] [Full Text] [PDF]