Clinical Features, Surgical Treatment and Prognosis in Acute Myocardial Infarction Patients With Ventricular Septal Rupture Complicating Cardiogenic Shock
10.3969/j.issn.1000-3614.2017.09.008
- VernacularTitle:急性心肌梗死合并室间隔穿孔及并发心原性休克患者的临床特点及外科治疗预后
- Author:
mei Han LI
1
;
Shen LIU
;
ping Jian XU
;
Feng LV
;
song Han SUN
;
shou Sheng HU
;
hu Yun SONG
Author Information
1. 中国医学科学院北京协和医学院国家心血管病中心阜外医院成人外科中心
- Keywords:
Myocardial infarction,Ventricular septal rupture;
Shock
- From:
Chinese Circulation Journal
2017;32(9):864-868
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical features,surgical treatment and prognosis in acute myocardial infarction (AMI) patients with ventricular septal rupture (VSR) complicating cardiogenic shock (CS).Methods:A total of 77 AMI-VSR patients received surgical repair in our hospital from 2005-01 to 2015-05 were retrospectively studied.The patients were divided into 2 groups:CS group n=52 and Without CS group,n=25.Clinical features were compared between 2 groups and the outcomes in CS group were analyzed.Results:Both groups showed multiple aneurysm (73.0％ vs 68.0％);CS was more occurred in patients with posterior VSR (48.0％ vs 24.0％),P=0.044.Compared to Without CS group,CS group had the larger diameter of VSR (16.16±6.73) mm vs (11.86±4.62) mm,P=0.003;lower LVEF (45.0±8.8) ％ vs (47.9±12.3) ％,higher pre-operative application rates of IABP (34.6％ vs 0％) and vasoactive drugs (96.2％ vs 28.0％),more patients received emergent surgery (42.3％ vs 8.0％) and less patients received elective surgery (57.7％ vs 92.0％),all P＜0.05.In CS group,there were 3 in-hospital death,49 patients survived with the mean follow-up time at (4.5±3.1) years and 2 patients died during that period.Conclusion:Larger or posterior VSR were more likely to develop CS,the patients survived after surgical treatment may have good mid-term outcomes.
