title: Clinical and surgical profile of patients operated for postinfarction interventricular septal rupture.
abstract: OBJECTIVE
  To study clinical features, complications and in-hospital outcomes of patients operated for postinfarction ventricular septal rupture.
  
  
  METHODS
  A retrospective study involving 21 patients between January/1996 and June/2009. All operations were performed at the Division of Cardiovascular Surgery of Complexo Hospitalar HUOC/PROCAPE.
  
  
  RESULTS
  Mean age of patients was 62.81 years (± 8.21), 61.9% (n = 13) were male. Rupture occurred on average 4.8 days after infarction. Cardiogenic shock was observed in 57.1% (n = 12), being risk factor for death (100% with shock vs. 22.2% without shock; P<0.001). Survivors had a higher mean ejection fraction compared to deaths (66.29% ± 4.61% versus 42.71% ± 4.79%, P <0.001). All were classified as high risk by the EuroSCORE, and the survivors had lower average score compared to deaths (6.57 ± 0.53 versus 10.93 ± 2.23; P <0.001). The majority (76.2%, n = 16) of the patients needed to use vasoactive drugs and 57.1% (n = 12) considered hemodynamically unstable. Need for vasoactive drugs was a risk factor for death (81.3% with vasoactive drugs versus 20% without vasoactive drugs, P = 0.025). Hemodynamic instability was also a risk factor for death (100% in the unstable group versus 22.2% in the stable group; P <0.001). The rate of in-hospital mortality was 66.7% (n = 14).
  
  
  CONCLUSIONS
  The need for vasoactive drugs, hemodynamic instability and cardiogenic shock were associated with higher rates of mortality. Patients who had adverse outcomes had less ventricular function and higher score in the EuroSCORE. Mortality remains high.
authors.affiliation: Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brazil. michel_pompeu@yahoo.com.br
authors.forename: Michel Pompeu Barros de Oliveira
authors.initials: MP
authors.lastname: Sá
authors.forename: Marcus Villander Barros de Oliveira
authors.initials: MV
authors.lastname: Sá
authors.forename: Caio Henrique
authors.initials: CH
authors.lastname: Barbosa
authors.forename: Niedjon Peixoto de Carvalho
authors.initials: NP
authors.lastname: Silva
authors.forename: Rodrigo Renda de
authors.initials: RR
authors.lastname: Escobar
authors.forename: Fábio Gonçalves de
authors.initials: FG
authors.lastname: Rueda
authors.forename: Frederico Pires Vasconcelos
authors.initials: FP
authors.lastname: Silva
authors.forename: Ricardo de Carvalho
authors.initials: Rde C
authors.lastname: Lima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D018658:Ventricular Septal Rupture / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000601:surgery*
chemical_list: D014662:Vasoconstrictor Agents