Surgical treatment and prognosis of myocardial infarction complicated with ventricular septal perforation
- VernacularTitle:心肌梗死合并室间隔穿孔的外科治疗及预后分析
- Author:
Taoshuai LIU
1
;
Weiye LIU
2
,
3
;
Zhuhui HUANG
1
;
Yang ZHAO
1
;
Jubing ZHENG
1
;
Ran DONG
1
Author Information
1. Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P.R.China
2. Department of Critical Care Medicine, The People'
3. s Hospital of Zhaoyuan City, Zhaoyuan, 265400, Shandong, P.R.China
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
ventricular septal perforation;
surgical repair;
treatment
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(09):1061-1065
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the surgical methods and efficacy of myocardial infarction combined with ventricular septal perforation. Methods The clinical data of 60 patients with myocardial infarction combined with ventricular septal perforation admitted to the Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, from 2009 to 2018 were retrospectively analyzed. There were 39 males and 21 females, aged 63.3±8.3 years. Results Among the 60 patients, 43 (71.7%) patients were perforated in the apex, 11 (18.3%) in the posterior septum and 6 (10.0%) in the anterior septum. There were 24 (40.0%) patients of single coronary artery disease. Fourteen (23.3%) patients received intra-aortic balloon counterpulsation before surgery. The waiting time from ventricular septal perforation to surgery was 48.3 (3-217) d. All patients underwent ventricular septal perforation repair, among whom 53 (88.3%) patients received ventricular aneurysm closure or resection, and 49 (81.7%) patients received coronary artery bypass graft with an average of 2 distal anastomoses during the same period. Perioperative complications in the hospital included 8 (13.3%) deaths, 8 (13.3%) heart failure, 5 (8.3%) ventricular fibrillation, 3 (5.0%) pericardial tamponade, and 11 (18.3%) secondary thoracotomy and 11 (18.3%) residual shunt. Except for 8 patients who died in the hospital, the other 52 cured and discharged patients were followed up. The median follow-up time was 4.9 years. The 2-year and 5-year survival rate of the patients was 95.8%, and the 8-year survival rate was 89.0%. Major adverse cardiovascular events incidence was 19.2%, including 3 (5.8%) deaths, 5 (9.6%) heart failure, 2 (3.8%) myocardial infarction, and 4 (7.7%) cerebrovascular events. Conclusion For patients with ventricular septal perforation after myocardial infarction, surgery is an effective treatment method. Although the perioperative mortality rate is high, satisfactory long-term results can be achieved by carefully choosing the operation timing and methods.
