Conduits selection for surgical repair of ventricular septal rupture combined with concurrent coronary artery bypass grafting
- VernacularTitle:室间隔穿孔外科修复同期行冠状动脉旁路移植术的桥血管选择
- Author:
Jiexu MA
1
;
Xinhe XU
1
;
Hang XU
1
;
Zhaoji ZHONG
1
;
Sheng LIU
1
Author Information
1. Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
ventricular septal rupture;
acute myocardial infarction;
surgery;
coronary artery bypass grafting;
arterial conduit
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(05):766-771
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of graft type on perioperative outcomes and long-term prognosis in patients undergoing surgical repair of post-myocardial infarction ventricular septal rupture (VSR) with concurrent coronary artery bypass grafting (CABG). Methods A retrospective analysis was conducted on clinical data from patients who underwent VSR repair and concurrent CABG at Fuwai Hospital between 2005 and 2022. Patients were divided into an arterial graft group and a saphenous vein graft (SVG)-only group based on the type of bypass grafts used. Clinical outcomes were compared between the two groups. Results A total of 92 patients were included, comprising 56 males and 36 females, with a mean age of (62.4±7.9) years. The arterial graft group consisted of 60 patients, and the SVG-only group consisted of 32 patients. There were no statistical differences between the two groups in age, gender, body mass index, past medical history, time interval from myocardial infarction to surgery, or culprit vessel distribution (P>0.05). A higher proportion of patients in the SVG-only group received preoperative intra-aortic balloon pump (IABP) support (56.3% vs. 35.0%, P=0.049). However, cardiopulmonary bypass time, aortic cross-clamp time, and early mortality rates were similar between the two groups (P>0.05). Follow-up data revealed no statistically significant differences in cumulative 10-year survival (82.8% vs. 80.0%, P=0.940) or freedom from major adverse cardiovascular and cerebrovascular events (49.6% vs. 58.6%, P=0.491) between the SVG-only and arterial graft groups. Furthermore, graft type did not significantly affect long-term mortality in patients with a culprit vessel in the left anterior descending artery or those with multivessel disease. Conclusion In patients undergoing delayed repair of VSR with concomitant CABG, the use of arterial or saphenous vein grafts does not significantly impact perioperative outcomes or long-term prognosis. Future research should further explore the benefits of different revascularization strategies to optimize treatment for this population.
