Application of modified percutaneous closure in the treatment of ventricular septal rupture after acute myocardial infarction
10.3760/cma.j.cn112148-20231201-00477
- VernacularTitle:改良经皮封堵术在急性心肌梗死后室间隔穿孔中的应用
- Author:
Zirui SUN
1
;
Yu HAN
;
Yuhao LIU
;
Jicheng JIANG
;
Yan HAN
;
Lele BEN
;
Jing ZHANG
;
Chuanyu GAO
Author Information
1. 阜外华中心血管病医院（郑州大学华中阜外医院）河南省人民医院心脏中心 结构性心脏病科，郑州 450000
- Keywords:
Myocardial infarction;
Ventricular septal rupture;
Percutaneous closure;
Modified technique
- From:
Chinese Journal of Cardiology
2024;52(12):1412-1416
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of modified percutaneous closure in the treatment of ventricular septal rupture.Methods:This study is a retrospective cohort study. Forty-four patients with ventricular septal rupture who underwent percutaneous closure at the Fuwai Central China Cardiovascular Hospital from December 2017 to October 2023 were included. According to the closure method, patients were divided into the modified group (11 cases) and the traditional group (33 cases). Surgical success was defined as successful placement of the occluder. The operation time, X-ray intake, sheath bending rate, incidence of ventricular fibrillation and pericardial tamponade, and postoperative residual shunt were compared between the two groups.Results:The age of the patients was (75.0±5.7) years, with 20 (45%) males. There were 3 cases of operation failure in the traditional group, while all patients in the modified group were successfully occluded. The procedure time in the modified group was shorter than that in the traditional group (40 (35, 45) min vs. 60 (50, 65)min, P<0.001); X-ray dose intake was lower ((442.43±73.26)mGy vs. (784.45±247.78)mGy, P<0.001). There was no occurrence of sheath bending in the modified group, while the incidence of sheath bending in the traditional surgery group was 46% (15/33), and the difference was statistically significant ( P=0.017). Intraoperative ventricular fibrillation and pericardial tamponade occurred in 7 cases (21%) and 2 cases (6%) in the traditional group respectively, while none occurred in the modified group, but the differences between the groups were not statistically significant (both P>0.05). There was no significant difference in residual shunt between the two groups (3.6 (2.5, 4.3) mm vs. 4.0 (3.5, 4.5) mm, P=0.506). Conclusion:The procedure of modified ventricular septal rupture closure is more simplified, with a lower incidence ofventricular fibrillation and pericardial tamponade.
