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http://hdl.handle.net/2445/190760
Title: | Optimal surgical timing after post-infarction ventricular septal rupture |
Author: | Sánchez Vega, Juan Diego Alonso Salinas, Gonzalo Luis Viéitez Florez, José María Ariza Solé, Albert López De Sá, Esteban Sanz Ruiz, Ricardo Burgos Palacios, Virginia Raposeiras Roubin, Sergio Gómez Varela, Susana Sanchís Forés, Juan Silva Melchor, Lorenzo Martínez Seara, Xurxo Malagón López, Lorena Viana Tejedor, Ana Corbí Pascual, Miguel Zamorano Gómez, José Luis Sanmartín Fernández, Marcelo |
Keywords: | Infart de miocardi Myocardial infarction |
Issue Date: | 30-Sep-2022 |
Publisher: | VM Media SP. zo.o VM Group SK |
Abstract: | Background: Ventricular septal rupture (VSR) following acute myocardial infarction (AMI) is a dan-gerous condition. Surgical VSR closure is the definitive therapy, but there is controversy regarding the surgical timing and the bridging therapy between diagnosis and intervention. The objective of this study is to analyze the ideal time of surgical repair and to establish the contribution of mechanical circulatory support (MCS) devices on the prognosis. Methods: We designed an observational, retrospective, multicenter study, selecting all consecutive patients with post-AMI VSR between January 1, 2008 and December 31, 2018, with non-exclusion criteria. The main objective of this study was to analyze the optimal timing for surgical repair of post-AMI VSR. Second- ary endpoints were to determine which factors could influence mortality in the patients of the surgical group. Results: A total of 141 patients were included. We identified lower mortality rates with an odds ratio of 0.3 (0.1 & ndash;0.9) in patients operated on from day 4 compared with the surgical mortality in the first 24 hours after VSR diagnosis. The use of MCS was more frequent in patients treated with surgery, par- ticularly for intra-aortic balloon pump (IABP; 79.6% vs. 37.8%, p < 0.001), but also for veno-arterial extracorporeal membrane oxygenation (VA-ECMO; 18.2% vs. 6.4%, p = 0.134). Total mortality was 91.5% for conservative management and 52.3% with surgical repair (p < 0.001). Conclusions: In our study, we observed that the lowest mortality rates in patients with surgical repair of post-AMI VSR were observed in patients operated on from day 4 after diagnosis of VSR, compared to earlier interventions. (Cardiol J 2022; 29, 5: 773 & ndash;781) |
Note: | Reproducció del document publicat a: https://doi.org/10.5603/CJ.a2022.0035 |
It is part of: | Cardiology Journal, 2022, vol. 29, issue. 5, p. 773-781 |
URI: | http://hdl.handle.net/2445/190760 |
Related resource: | https://doi.org/10.5603/CJ.a2022.0035 |
ISSN: | 1898-018X |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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