[The early and middle-long term clinical results of surgical treatment for ventricular septal rupture].
OBJECTIVE
To explore the way of promoting the efficacy of surgical treatment for ventricular septal rupture (VSR) after acute myocardium infarction in terms of perioperative and long term survival.


METHODS
The clinic data of 37 VSR cases underwent surgical treatment from October 1994 to October 2007 were analyzed retrospectively. There were 24 male and 13 female, and the age was (63.4 +/- 7.6) years old. The whole group was divided into the VSR repair plus revascularization group (group A, 26 cases) and simple VSR repair group (group B, 11 cases).


RESULTS
There were 4 operative deaths in group A (15.4%), 7 deaths in group B (63.6%), P = 0.006. With the follow-up of (34.0 +/- 29.8) months ranged from 2 to 103 months of the 26 operational survivors, there were 5 late deaths, of which 2 deaths in group A and 3 deaths in group B. According to the Kaplan-Meier survival curve, the actuarial survival rate at 6 to 8 year was (64.3 +/- 21.0)% for group A and the actuarial survival rate at 4 year was (25.0 +/- 21.7)% for group B, P = 0.011. Of the 21 mid-long term survivors, 17 cases were in NYHA class I to II and 4 cases in NYHA class III to IV. There were 4 cases suffered from VSR recurrence. According to Logistic regression, the risk factors for the early death were not adoptive of revascularization, cardiogenic shock and emergency surgical procedure, while the risk factors for late death were not adoptive of revascularization and low cardiac output after the procedures.


CONCLUSIONS
VSR repair plus revascularization could improve the perioperative and mid-long term survival for the surgical treatment of VSR. The appropriate timing and procedures of the surgical operation are very important to promote perioperative survival and to prevent VSR recurrence.
Gan
Hui-Li
HL
Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China. ganhuili@hotmail.com
Zhang
Jian-Qun
JQ
Chen
Bao-Tian
BT
Zhou
Qi-Wen
QW
Gu
Cheng-Xiong
CX
Huang
Fang-Jiong
FJ
Wang
Sheng-Xun
SX
Zheng
Si-Hong
SH
Mu
Jun-Sheng
JS
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006342:Heart Rupture, Post-Infarction / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome; D018658:Ventricular Septal Rupture / Q000209:etiology / Q000601:surgery*