title: Surgical repair of postinfarction ventricular septal rupture: risk factors of early and late death.
abstract: OBJECTIVE
  The aim of the study was to identify risk factors of early and late death after surgical repair of postinfarction ventricular septal rupture.
  
  
  METHODS
  During a 25-year period, from May 1981 to August 2006, 102 patients underwent repair of postinfarction ventricular septal rupture. Data were collected on clinical, angiographic, and echocardiographic findings; operative procedures; early morbidity; and survival time. Univariable and multivariable analyses were performed to identify risk factors of 30-day mortality and total mortality.
  
  
  RESULTS
  Thirty-day mortality was 33% altogether and decreased from 45% in the first half to 21% in the second half of the period (P = .01). Follow-up was a mean of 5.2 +/- 6.2 years and a median of 2.9 years (range, 0-26.3 years). Five- and 10-year cumulative survival was 50% and 32%, respectively. Shock at surgical intervention and incomplete coronary revascularization were strong and independent risk factors of both 30-day mortality and poor long-term survival.
  
  
  CONCLUSIONS
  Early outcome after repair of ventricular septal rupture improved significantly during time, with 30-day mortality being 21% in the last decade. Five- and 10-year cumulative survival was 50% and 32%, respectively. Shock at surgical intervention and incomplete coronary revascularization were strong and independent predictors of poor early and late survival.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Rikshospitalet, Oslo, Norway. rulund@rikshospitalet.no
authors.forename: Runar
authors.initials: R
authors.lastname: Lundblad
authors.forename: Michel
authors.initials: M
authors.lastname: Abdelnoor
authors.forename: Odd R
authors.initials: OR
authors.lastname: Geiran
authors.forename: Jan L
authors.initials: JL
authors.lastname: Svennevig