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Decision making, management, and midterm outcomes of postinfarction ventricular septal rupture: Our experience with 21 patients


1 Department of Cardiac Anesthesiology, Apollo Hospitals, Bhubaneswar, Odisha, India
2 Department of Cardiothoracic and Vascular Surgery, Apollo Hospitals, Bhubaneswar, India
3 Department of Pharmacy, Talla Padmavathi College of Pharmacy, Warangal, Telangana, India

Correspondence Address:
Samarjit Bisoyi
Department of Cardiac Anesthesiology, Apollo Hospitals, Sainik School Road, Plot No. 251, Bhubaneswar - 751 005, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_119_19

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Year : 2020  |  Volume : 23  |  Issue : 4  |  Page : 471-476

 

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Context: Ventricular septal rupture (VSR) is a dreaded complication following myocardial infarction. Surgical repair of VSR is associated with significant early mortality. Variable outcomes in terms of early mortality and midterm functional status have been reported from different centers. Aims: In our study, we attempt to review the experience of decision making and surgical repair of postinfarction VSR, and to analyze the factors contributing to the early mortality and midterm outcome after repair. Materials and Methods: It is a retrospective study. Data were summarized retrospectively by frequencies and percentages for categorical factors, and means and standard deviations for continuous factors. Multivariate logistic regression, odds ratios, 95% confidence intervals, and P value were calculated for different variables to determine their independent effect on operative mortality. All surviving patients answered the EQ-5D Health Questionnaire. Results: Preoperative renal failure, left ventricular dysfunction (moderate and severe), and Killip class (III and IV) were significantly associated with early mortality after surgery. Small residual ventricular septal defect (VSD) was not found to affect the midterm quality of life. Conclusions: Early surgical repair benefits the patient by preventing early end-organ damage. The renal failure left ventricular dysfunction (moderate and severe) and Killip class (III and IV) adversely affect early outcomes after surgery. Small residual ventricular septal defect (VSD) does not affect the midterm quality of life.






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1 Department of Cardiac Anesthesiology, Apollo Hospitals, Bhubaneswar, Odisha, India
2 Department of Cardiothoracic and Vascular Surgery, Apollo Hospitals, Bhubaneswar, India
3 Department of Pharmacy, Talla Padmavathi College of Pharmacy, Warangal, Telangana, India

Correspondence Address:
Samarjit Bisoyi
Department of Cardiac Anesthesiology, Apollo Hospitals, Sainik School Road, Plot No. 251, Bhubaneswar - 751 005, Odisha
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_119_19

Rights and Permissions

Context: Ventricular septal rupture (VSR) is a dreaded complication following myocardial infarction. Surgical repair of VSR is associated with significant early mortality. Variable outcomes in terms of early mortality and midterm functional status have been reported from different centers. Aims: In our study, we attempt to review the experience of decision making and surgical repair of postinfarction VSR, and to analyze the factors contributing to the early mortality and midterm outcome after repair. Materials and Methods: It is a retrospective study. Data were summarized retrospectively by frequencies and percentages for categorical factors, and means and standard deviations for continuous factors. Multivariate logistic regression, odds ratios, 95% confidence intervals, and P value were calculated for different variables to determine their independent effect on operative mortality. All surviving patients answered the EQ-5D Health Questionnaire. Results: Preoperative renal failure, left ventricular dysfunction (moderate and severe), and Killip class (III and IV) were significantly associated with early mortality after surgery. Small residual ventricular septal defect (VSD) was not found to affect the midterm quality of life. Conclusions: Early surgical repair benefits the patient by preventing early end-organ damage. The renal failure left ventricular dysfunction (moderate and severe) and Killip class (III and IV) adversely affect early outcomes after surgery. Small residual ventricular septal defect (VSD) does not affect the midterm quality of life.






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