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  • Title: Surgical repair of postinfarction ventricular septal rupture: risk factors of early and late death.
    Author: Lundblad R, Abdelnoor M, Geiran OR, Svennevig JL.
    Journal: J Thorac Cardiovasc Surg; 2009 Apr; 137(4):862-8. PubMed ID: 19327509.
    Abstract:
    OBJECTIVE: The aim of the study was to identify risk factors of early and late death after surgical repair of postinfarction ventricular septal rupture. METHODS: During a 25-year period, from May 1981 to August 2006, 102 patients underwent repair of postinfarction ventricular septal rupture. Data were collected on clinical, angiographic, and echocardiographic findings; operative procedures; early morbidity; and survival time. Univariable and multivariable analyses were performed to identify risk factors of 30-day mortality and total mortality. RESULTS: Thirty-day mortality was 33% altogether and decreased from 45% in the first half to 21% in the second half of the period (P = .01). Follow-up was a mean of 5.2 +/- 6.2 years and a median of 2.9 years (range, 0-26.3 years). Five- and 10-year cumulative survival was 50% and 32%, respectively. Shock at surgical intervention and incomplete coronary revascularization were strong and independent risk factors of both 30-day mortality and poor long-term survival. CONCLUSIONS: Early outcome after repair of ventricular septal rupture improved significantly during time, with 30-day mortality being 21% in the last decade. Five- and 10-year cumulative survival was 50% and 32%, respectively. Shock at surgical intervention and incomplete coronary revascularization were strong and independent predictors of poor early and late survival.
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