title: Results of early repair of ventricular septal defect after an acute myocardial infarction.
abstract: A 10-year experience with early operation for postinfarction ventricular septal defect is reviewed. Twenty-two patients underwent surgical repair; operative mortality was 36% (< 30 days). The actuarial survival was 64% at 1 month, 59% at 1 year, and 47% at 5 years. Risk factors predictive of operative mortality were diabetes (p = 0.001), elevated preoperative right atrial pressure (p = 0.02), the absence of a preoperative intraaortic balloon pump (p = 0.006), and a short time interval between infarct and operation (p = 0.018). Long-term survival was adversely related to diabetes (p = 0.030), elevated preoperative right atrial pressure (p = 0.005), and, surprisingly, survival was better in patients with a greater extent of coronary artery disease (p = 0.023). There were 14 operative survivors (64%) and 11 long-term survivors (3 months to 10 years, mean 6.0 +/- 3.5 years). Six of eleven survivors were in functional New York Heart Association class I, one was in class II, and four were in class III.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif. 90048.
authors.forename: C
authors.initials: C
authors.lastname: Blanche
authors.forename: S S
authors.initials: SS
authors.lastname: Khan
authors.forename: J M
authors.initials: JM
authors.lastname: Matloff
authors.forename: A
authors.initials: A
authors.lastname: Chaux
authors.forename: M A
authors.initials: MA
authors.lastname: DeRobertis
authors.forename: L S
authors.initials: LS
authors.lastname: Czer
authors.forename: R M
authors.initials: RM
authors.lastname: Kass
authors.forename: T P
authors.initials: TP
authors.lastname: Tsai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000401:mortality / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors