Surgical repair for ventricular septal rupture in 105 patients complicating with acute myocardial infarction: Fuwai Hospital’s 16 years’ follow-up results_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Hanmei , XIANG Li , XU Jianping , SUN Hansong ,  SONG Yunhu

Center of Adult Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China;

Corresponding author：

SONG Yunhu, Email: heartcenter_song@hotmail.com

Keywords：

Ventricular septal rupture; long-term outcome; surgical treatment

DOI：

10.7507/1007-4848.201901055

Video：

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Objective To explore our novel strategy of surgical treatment for ventricular septal rupture (VSR) and the long-term outcomes.Methods All the patients referred to the Center of Adult Surgery, Fuwai Hospital were treated with integration treatment of vasoactive agents, intra-aortic balloon pump, or left ventricular assist device. The timing of surgical treatment was individually customized. One hundred and five consecutive patients with VSR (63 males, 42 females ) presented at the mean age of 63 (range, 41 to 80) years. We retrospectively analyzed the results and followed up patients who survived the surgical procedure.Results They were divided into a hemodynamics stable group (25 patients, 2 received emergent operation and 23 received selective operation) and a hemodynamics unstable group (80 patients, 34 received vasoactive agents and selective operation, 4 received vasoactive agents and emergent operation, 20 received vasoactive agent, intra-aortic balloon counterpulsation (IABP), and selective operation, 16 received vasoactive agents, IABP, and emergent operation, 2 received vasoactive agents, IABP, ventilator support, and selective operation, 2 received vasoactive agents, IABP, and ventilator support and emergent operation, 2 received vasoactive agents, ventilator support, and selective operation). There were 3 in-hospital deaths. Ninety-nine patients were followed up, with a follow-up rate of 97.1%. The mean follow-up time was 76.56±47.78 months. There were 2 late deaths during follow-up.Conclusion The timing of surgical treatment for ventricular septal rupture should be individually customized. The long-term outcomes of ventricular septal rupture patients who survived the surgery are satisfactory.

Citation： LI Hanmei, XIANG Li, XU Jianping, SUN Hansong, SONG Yunhu. Surgical repair for ventricular septal rupture in 105 patients complicating with acute myocardial infarction: Fuwai Hospital’s 16 years’ follow-up results. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(5): 451-456. doi: 10.7507/1007-4848.201901055 Copy

1.	李汉美, 孙晓刚. 急性心肌梗死后室间隔穿孔. 中国循环杂志, 2009, 24(5): 398-401.
2.	Cooley DA, Belmonte BA, Zeis LB, et al. Surgical repair of ruptured interventricular septum following acute myocardial infarction. Surg, 1957, 41: 930-937.
3.	David TE, Dale L, Sun Z. Postinfarction ventricular septal rupture: repair by endocardial patch with infarct exclusion. J Thorac Cardiovasc Surg, 1995, 110: 1315-1322.
4.	Moreyra AE, Huang MS, Wilson AC, et al. Trends in incidence and mortality rates of ventricular septal rupture during acute myocardial infarction. Am J Cardiol, 2010, 106(8): 1095-1100.
5.	Jeppsson A, Liden H, Johnsson P, et al. Surgical repair of post infarction ventricular septal defects: a national experience. Eur J Cardiothorac Surg, 2005, 27(2): 216-221.
6.	Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary. A report of the American College of Cardiology/American HeartAssociation Task Force on Practice Guidelines (Writing Committee to revise the 1999 guidelines for the management of patientswith acute myocardial infarction). J Am Coll Cardiol, 2004, 44: 671-719.
7.	Topaz O, Taylor AL. Interventricular septul rupture complicating acute myocardial infarction: from pathophysiologic features to the role of invasive and noninvasive diagnostic modalities in currentmanagement. Am J Med, 1992, 93: 683-688.
8.	Menon V, Webb JG, Hillis LJ, et al. Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: a report from the Shock Trial Registry. J Am Coll Cardiol, 2000, 36: 1110-1116.
9.	Crenshaw BS, Granger CB, Birnbaum Y, et al. Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction. Circulation, 2000, 101: 27-32.
10.	Birnbaum Y, Fishbein MC, Blanche C, et al. Ventricular septal rupture after acute myocardial infarction. N Engl J Med, 2002, 347: 1426-1432.
11.	Papalexopoulou N, Young CP, Attia RQ. What is the best timing of surgery in patients with post-infarct ventricular septal rupture? Interact Cardiovasc Thorac Surg, 2013, 16(2): 193-196.
12.	Huang SM, Huang SC, Wang CH, et al. Risk factors and outcome analysis after surgical management of ventricular septal rupture complicating acute myocardial infarction: a retrospective analysis. J Cardiothorac Surg, 2015, 10: 66.
13.	La Torre MW, Centofanti P, Attisani M, et al. Posterior ventricular septal defect in presence of cardiogenic shock: early implantation of the impella recover LP 5. 0 as a bridge to surgery. Tex Heart Inst J, 2011, 38(1): 42-49.
14.	Abu-Omar Y, Bhinda P, Choong CK, et al. Survival after surgical repair of ischemic ventricular septal rupture. Asian Cardiovasc Thorac Ann, 2012, 20: 404-408.
15.	Thiele H, Kaulfersch C, Daehnert I, et al. Immediate primary transcatheter closure of postinfarction ventricular septal ruptures. Eur Heart J, 2009, 30: 81-88.

1. 李汉美, 孙晓刚. 急性心肌梗死后室间隔穿孔. 中国循环杂志, 2009, 24(5): 398-401.
2. Cooley DA, Belmonte BA, Zeis LB, et al. Surgical repair of ruptured interventricular septum following acute myocardial infarction. Surg, 1957, 41: 930-937.
3. David TE, Dale L, Sun Z. Postinfarction ventricular septal rupture: repair by endocardial patch with infarct exclusion. J Thorac Cardiovasc Surg, 1995, 110: 1315-1322.
4. Moreyra AE, Huang MS, Wilson AC, et al. Trends in incidence and mortality rates of ventricular septal rupture during acute myocardial infarction. Am J Cardiol, 2010, 106(8): 1095-1100.
5. Jeppsson A, Liden H, Johnsson P, et al. Surgical repair of post infarction ventricular septal defects: a national experience. Eur J Cardiothorac Surg, 2005, 27(2): 216-221.
6. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary. A report of the American College of Cardiology/American HeartAssociation Task Force on Practice Guidelines (Writing Committee to revise the 1999 guidelines for the management of patientswith acute myocardial infarction). J Am Coll Cardiol, 2004, 44: 671-719.
7. Topaz O, Taylor AL. Interventricular septul rupture complicating acute myocardial infarction: from pathophysiologic features to the role of invasive and noninvasive diagnostic modalities in currentmanagement. Am J Med, 1992, 93: 683-688.
8. Menon V, Webb JG, Hillis LJ, et al. Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: a report from the Shock Trial Registry. J Am Coll Cardiol, 2000, 36: 1110-1116.
9. Crenshaw BS, Granger CB, Birnbaum Y, et al. Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction. Circulation, 2000, 101: 27-32.
10. Birnbaum Y, Fishbein MC, Blanche C, et al. Ventricular septal rupture after acute myocardial infarction. N Engl J Med, 2002, 347: 1426-1432.
11. Papalexopoulou N, Young CP, Attia RQ. What is the best timing of surgery in patients with post-infarct ventricular septal rupture? Interact Cardiovasc Thorac Surg, 2013, 16(2): 193-196.
12. Huang SM, Huang SC, Wang CH, et al. Risk factors and outcome analysis after surgical management of ventricular septal rupture complicating acute myocardial infarction: a retrospective analysis. J Cardiothorac Surg, 2015, 10: 66.
13. La Torre MW, Centofanti P, Attisani M, et al. Posterior ventricular septal defect in presence of cardiogenic shock: early implantation of the impella recover LP 5. 0 as a bridge to surgery. Tex Heart Inst J, 2011, 38(1): 42-49.
14. Abu-Omar Y, Bhinda P, Choong CK, et al. Survival after surgical repair of ischemic ventricular septal rupture. Asian Cardiovasc Thorac Ann, 2012, 20: 404-408.
15. Thiele H, Kaulfersch C, Daehnert I, et al. Immediate primary transcatheter closure of postinfarction ventricular septal ruptures. Eur Heart J, 2009, 30: 81-88.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical repair for ventricular septal rupture in 105 patients complicating with acute myocardial infarction: Fuwai Hospital’s 16 years’ follow-up results

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