Post-infarction ventricular septal defect: Risk factors and early outcomes

Pranas Serpytis, Neringa Karvelyte, Rokas Serpytis, Gintaras Kalinauskas, Kestutis Rucinskas, Robertas Samalavicius, Justinas Ivaska, Sigita Glaveckaite, Egidijus Berukstis, Marco Tubaro, Joseph S. Alpert, Aleksandras Laucevičius

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: Rupture of the ventricular septum complicates acute myocardial infarction in 0.2% of cases in the thrombolytic era. Ventricular septal defect (VSD) has a mortality of 90-95% in medically managed and 19-60% in surgically treated patients. Methods: A retrospective analysis was performed of 41 patients, 26 females (63.4%) and 15 males (36.6%), average age 67.5 ± 15 years, with post-infarction VSD who were treated in the VUL SK intensive cardiology unit between 1991 and 2007. Results: Thirty-seven patients had hypertension (90.2%); anterior wall acute myocardial infarction (AMI) was found in 27 patients (68%). VSD was more frequent in women than in men (p=0.043). In 36 patients (87%) treatment was started 24 hours or later after the development of AMI symptoms. In 34 patients (83%) the rupture occurred during the first episode of AMI and in the majority of these (19 patients, 46.3%), preoperative coronary angiography demonstrated disease of only one coronary artery. During the first 10 days after the onset of AMI, 5 patients (12.2%) were treated surgically but did not survive the operation; 33 patients (80.5%) underwent operation 3-4 weeks after the onset of AMI and all survived. Conclusions: Female sex, advanced age, arterial hypertension, anterior wall AMI, absence of previous AMI, and late arrival at hospital are associated with a higher risk of mortality from acute VSD. The most important factor that determines operative mortality and intra-hospital survival is the time from the onset of AMI to operation.

Original languageEnglish (US)
Pages (from-to)66-71
Number of pages6
JournalHellenic Journal of Cardiology
Volume56
Issue number1
StatePublished - Jan 1 2015

Keywords

  • Acute coronary syndrome
  • Acute myocardial infarction
  • Inhospital survival
  • Ventricular septal defect

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Post-infarction ventricular septal defect: Risk factors and early outcomes'. Together they form a unique fingerprint.

  • Cite this

    Serpytis, P., Karvelyte, N., Serpytis, R., Kalinauskas, G., Rucinskas, K., Samalavicius, R., Ivaska, J., Glaveckaite, S., Berukstis, E., Tubaro, M., Alpert, J. S., & Laucevičius, A. (2015). Post-infarction ventricular septal defect: Risk factors and early outcomes. Hellenic Journal of Cardiology, 56(1), 66-71.