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

7 Citations (Scopus)

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 - 2015

Fingerprint

Ventricular Heart Septal Defects
Infarction
Myocardial Infarction
Anterior Wall Myocardial Infarction
Rupture
Hypertension
Ventricular Septum
Mortality
Hospital Mortality
Cardiology
Coronary Angiography
Coronary Vessels
Survival

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Serpytis, P., Karvelyte, N., Serpytis, R., Kalinauskas, G., Rucinskas, K., Samalavicius, R., ... Laucevičius, A. (2015). Post-infarction ventricular septal defect: Risk factors and early outcomes. Hellenic Journal of Cardiology, 56(1), 66-71.

Post-infarction ventricular septal defect : Risk factors and early outcomes. / Serpytis, Pranas; Karvelyte, Neringa; Serpytis, Rokas; Kalinauskas, Gintaras; Rucinskas, Kestutis; Samalavicius, Robertas; Ivaska, Justinas; Glaveckaite, Sigita; Berukstis, Egidijus; Tubaro, Marco; Alpert, Joseph S; Laucevičius, Aleksandras.

In: Hellenic Journal of Cardiology, Vol. 56, No. 1, 2015, p. 66-71.

Research output: Contribution to journalArticle

Serpytis, P, Karvelyte, N, Serpytis, R, Kalinauskas, G, Rucinskas, K, Samalavicius, R, Ivaska, J, Glaveckaite, S, Berukstis, E, Tubaro, M, Alpert, JS & Laucevičius, A 2015, 'Post-infarction ventricular septal defect: Risk factors and early outcomes', Hellenic Journal of Cardiology, vol. 56, no. 1, pp. 66-71.
Serpytis P, Karvelyte N, Serpytis R, Kalinauskas G, Rucinskas K, Samalavicius R et al. Post-infarction ventricular septal defect: Risk factors and early outcomes. Hellenic Journal of Cardiology. 2015;56(1):66-71.
Serpytis, Pranas ; Karvelyte, Neringa ; Serpytis, Rokas ; Kalinauskas, Gintaras ; Rucinskas, Kestutis ; Samalavicius, Robertas ; Ivaska, Justinas ; Glaveckaite, Sigita ; Berukstis, Egidijus ; Tubaro, Marco ; Alpert, Joseph S ; Laucevičius, Aleksandras. / Post-infarction ventricular septal defect : Risk factors and early outcomes. In: Hellenic Journal of Cardiology. 2015 ; Vol. 56, No. 1. pp. 66-71.
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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.",
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T1 - Post-infarction ventricular septal defect

T2 - Risk factors and early outcomes

AU - Serpytis, Pranas

AU - Karvelyte, Neringa

AU - Serpytis, Rokas

AU - Kalinauskas, Gintaras

AU - Rucinskas, Kestutis

AU - Samalavicius, Robertas

AU - Ivaska, Justinas

AU - Glaveckaite, Sigita

AU - Berukstis, Egidijus

AU - Tubaro, Marco

AU - Alpert, Joseph S

AU - Laucevičius, Aleksandras

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

KW - Acute coronary syndrome

KW - Acute myocardial infarction

KW - Inhospital survival

KW - Ventricular septal defect

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