title: [Clinical characteristics and treatment of ventricular septum rupture after acute myocardial infarction].
abstract: OBJECTIVE
  To identify the characteristics, management strategy and mortality of patients with acute myocardial infarction (AMI) and rupture of ventricular septum (RVS).
  
  
  METHODS
  The study included 40 patients admitted during a period of 8 years, due to AMI complicated with RVS. RVS was confirmed by echocardiogram. The clinical characteristics, type of treatment and hospital mortality were evaluated. Variables were compared by Mann-Withney U tests or Fisher exact test.
  
  
  RESULTS
  Patients were 64 years old (56 - 73), 67% men, 53% diabetes mellitus, 43% hypertension, 40% smokers. Treatments were medical (45%), surgical (38%) or Amplatzer (17%). Overall mortality was 65%, in conservative group was 45%, in surgery group 38%, and Amplatzer group 17% (p = 0.02), it was associated to shorter time between AMI and RVS (p <0.001) and shorter time between and treatment (p <0.001). All patients with Killipp Kimbal III or IV died.
  
  
  CONCLUSIONS
  Currently there is no management strategy in RSV with demonstrated advantage over other strategies. The only marker with good prognosis could be a long time between rupture and treatment. It is likely that the indication of management of International guidelines does not apply to all patients and these should be stratified according to their hemodynamic status.
authors.affiliation: Departamento de Urgencias y Unidad Coronaria.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rojas-Velasco
authors.forename: Claudia
authors.initials: C
authors.lastname: Lerma
authors.forename: Alexandra
authors.initials: A
authors.lastname: Arias-Mendoza
authors.forename: Amada
authors.initials: A
authors.lastname: Álvarez-Sangabriel
authors.forename: Alfredo
authors.initials: A
authors.lastname: Altamirano
authors.forename: Francisco
authors.initials: F
authors.lastname: Azar-Manzur
authors.forename: Úrsulo
authors.initials: Ú
authors.lastname: Juárez-Herrera
authors.forename: Carlos
authors.initials: C
authors.lastname: Martínez-Sánchez
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D012189:Retrospective Studies; D018658:Ventricular Septal Rupture / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*