Surgical repair of post-infarction ventricular septal defect: 19 years of experience.
OBJECTIVE
To review our experience of surgical repair of post-infarction ventricular septal defect (VSD).


METHODS
In the period 1983-2002, 50 patients underwent repair of VSD. Mean age was 66 years, male sex 52%. Infarct location was anterior in 60% and posterior in 40% of cases. Median interval between rupture and surgery was 2 days. Preoperative intra-aortic balloon counterpulsation was employed in 56%; a coronary angiogram was performed in 98% of cases. A patch repair technique was used in 90% of cases. Coronary bypass grafting was associated in 50% of patients.


RESULTS
Mean aortic clamp time was 101+/-31 min. Global operative mortality was 36%, respectively 26.7% in anterior and 50% in posterior location (p=ns). Emergency operation and interval from rupture to surgery less than 3 days were univariate predictor of early mortality. Five years survival excluding operative deaths was 76%.


CONCLUSIONS
The surgical repair of post-infarction VSD entails a high operative mortality; different techniques were employed with similar results. Emergency operation is associated with a worse short-term prognosis; long-term survival is acceptable.
Mantovani
Vittorio
V
Department of Cardiac Surgery, Ospedale di Circolo-Fondazione Macchi, Università dell'Insubria-Viale Borri 57, 21100 Varese, Italy. vitmantovani@hotmail.com
Mariscalco
Giovanni
G
Leva
Cristian
C
Blanzola
Claudio
C
Sala
Andrea
A
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D018658:Ventricular Septal Rupture / Q000401:mortality / Q000601:surgery*