Postinfarction ventricular septal defect--surgical strategies and results

Détails

ID Serval
serval:BIB_8124B752063A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Postinfarction ventricular septal defect--surgical strategies and results
Périodique
Thoracic and Cardiovascular Surgeon
Auteur(s)
von Segesser  L. K., Siebenmann  R., Schneider  K., Jenni  R., Gallino  A., Turina  M.
ISSN
0171-6425
Statut éditorial
Publié
Date de publication
04/1989
Peer-reviewed
Oui
Volume
37
Numéro
2
Pages
72-5
Notes
Journal Article --- Old month value: Apr
Résumé
Twenty consecutive patients with postinfarction ventricular septal defect (VSD) were subjected to surgery: there were 8 females and 12 males with a mean age of 67 +/- 9 years. Nine acute patients developed cardiogenic shock, and intra-aortic balloon pump was started before surgery (with IABP). Eight acute patients showed preoperatively relatively stable hemodynamics, and surgery was feasible without previous use of the intra-aortic balloon pump (without IABP). The interval between myocardial infarction and surgery was 13 days for 17 acute cases. In the group with IABP the interval was 8 +/- 5 days versus 19 +/- 11 days in the group without IABP (p less than 0.025). VSD patch closure was performed in 20/20, resection of infarct in 10/20, transventricular approach without resection of infarct in 3/20, patch enlargement of the left ventricle in 2/20, plicature of an aneurysm in 3/20, aorto-coronary bypass in 10/20 (number of bypasses: 2.1 +/- 1.3) and mitral annuloplasty in 1/20. The perioperative 30 days mortality was 5/20 (25%) for the whole series. In the group with IABP mortality was 4/9 (44%) versus 1/8 (13%) in the group of acute patients without IABP (p less than 0.05). Mean follow-up for the 15 surviving patients was 1.7 +/- 1.0 years. Two patients died during the first year, one of them due to carcinoma. After 1 year, mean NYHA functional class was assessed 1.5 +/- 0.6. One patient showed a residual VSD which was closed surgically. Immediate closure of a postinfarction ventricular septal defect is the therapy of choice of this complication of acute myocardial infarct with a natural history showing an extremely high mortality.
Mots-clé
Aged Female Follow-Up Studies Heart Septal Defects, Ventricular/*surgery Humans Male Middle Aged Myocardial Infarction/*surgery Postoperative Complications/mortality/*surgery Reoperation Risk Factors
Pubmed
Web of science
Création de la notice
14/02/2008 15:18
Dernière modification de la notice
03/03/2018 18:47
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