The analysis of survival factors and hemodynamic assessment by echocardiography in perioperative patients with ventricular septal perforation after acute myocardial infarction
10.3760/cma.j.issn.1004‐4477.2019.08.001
- VernacularTitle:超声对急性心肌梗死并发室间隔穿孔患者封堵术围手术期内血流动力学的评估
- Author:
Juan GUO
1
;
Hao WANG
;
Yuanting YANG
;
Renfeng YI
;
Zhiyong WU
;
Wei REN
;
Sheng CAO
;
Qin DENG
;
Qing ZHOU
Author Information
1. 武汉大学人民医院超声科
- Keywords:
Echocardiography;
Ventricular septal rupture;
Acute myocardial infarction
- From:
Chinese Journal of Ultrasonography
2019;28(8):645-650
- CountryChina
- Language:Chinese
-
Abstract:
To follow up and analyze patients with ventricular septal rupture( VSR) after acute myocardial infarction ( AM I) w ho underwent VSR occlusion ,screen the main risk factors of survival in perioperative patients with VSR after AM I ,and observe the postoperative cardiac function and hemodynamic changes by echocardiography . Methods Seventeen VSR patients were divided into the survival group ( 11 cases) and the death group ( 6 cases) within 30 days according to the survival time . T he changes of cardiac ultrasound parameters before and after the operation of VSR survivors were compared , and the hemodynamic recovery characteristics of VSR survivors were analyzed . Results Age ,the time to VSR occlusion ,preoperative left ventricular ejection fraction ,cardiogenic shock ,and the size of VSR were all the factors that were closely related to the 30‐day mortality of VSR with odds ratio of 0 .90 ( 95% CI 0 .73 to 1 .14 , P ＝0 .045) ,1 .89( 95% CI 1 .35 to 2 .23 , P ＝0 .003) ,0 .89( 95% CI 0 .57 to 1 .24 , P ＝0 .039) ,1 .45 ( 95% CI 1 .12 to 1 .78 , P ＝0 .027) and 11 .45( 95% CI 7 .89 to 15 .56 , P ＝0 .012) ,respectively ( all P＜0 .05 ) . Compared with the preoperative measurements , the left ventricular end‐diastolic volume and pulmonary artery systolic pressure were significantly reduced in the VSR survival group ( P ＜ 0 .05 ) . Conclusions The decrease of left ventricular end diastolic volume and pulmonary artery systolic pressure after operation indicates a better prognosis in the short period . Echocardiography is a vital tool in preoperative screening ,intraoperative monitoring and postoperative follow‐up in VSR occlusion .
