Surgical management of ventricular septal rupture following myocardial infarction: the Hawaii experience.
OBJECTIVE
To assess the diagnostic and treatment methods of ventricular septal rupture following myocardial infarction in a small patient population.


METHODS
Retrospective medical record review.


METHODS
Four Honolulu area teaching hospitals.


METHODS
Eighteen patients with ventricular septal rupture (VSR) following myocardial infarction (MI) between 1979 and 1993.


RESULTS
Ventricular septal rupture occurred more frequently in the elderly, in females and in those presenting for the first time with an MI. Thirteen patients (72%) underwent surgical repair including the two survivors. Three patients (17%) also underwent coronary artery bypass grafting, one of who survived. Very few of the patients had a history of stable angina pectoris before MI. Sudden deterioration in the patient's condition as manifested by tachycardia, hypotension and signs of right heart failure in those with an acute MI, especially if accompanied by a systolic murmur should encourage a search for a mechanical cause, especially a VSR.


CONCLUSIONS
Two dimensional echocardiography or Swan-Ganz catheterization is 100% diagnostic and can be rapidly done at the bed side. Early surgical repair is important to the overall prognosis.
Premaratne
S
S
Department of Surgery, John A. Burns School of Medicine, University of Hawaii, Honolulu 96813, USA.
Zhang
W
W
Arakaki
H Y
HY
Nakasone
C K
CK
McNamara
J J
JJ
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006254:Hawaii; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012189:Retrospective Studies; D018658:Ventricular Septal Rupture / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*