Postinfarction ventricular septal defect in the elderly: analysis and results.
Fifteen elderly patients (age more than 70 years) underwent surgical repair of postinfarction ventricular septal defects during the years 1980 through 1992. The operative (to discharge or < 30 days) mortality rate was 47%, and the complication rate among survivors was 63%. The probability of survival at 1 year was 47% +/- 13%. Because of the small sample size of our patient population, predictive preoperative risk factors associated with early mortality could not be identified with certainty. However, there is a trend suggesting that high right atrial pressures (p = 0.15) and the need of an intraaortic balloon pump preoperatively (p = 0.12) influence 30-day mortality, as previously described in larger series. Of 5 long-term survivors, 3 are in New York Heart Association functional class I and 2 are in class II. Our experience in this group of patients suggests that in the elderly, a very aggressive approach should be taken in recommending early surgical intervention for postinfarction ventricular septal defect before hemodynamic deterioration ensues and severely compromises chances for survival.
Blanche
C
C
Department of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Khan
S S
SS
Chaux
A
A
Matloff
J M
JM
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000401:mortality / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D015996:Survival Rate