title: Short-term and long-term outcomes of postinfarction ventricular septal perforation.
abstract: OBJECTIVE
  Ventricular septal perforation represents a serious complication after acute myocardial infarction. This study aimed to evaluate the short-term and longterm outcomes of postinfarction ventricular septal perforation (VSP).
  
  
  METHODS
  We evaluated outcomes for VSP repair for 42 patients over 19 years. A retrospective analysis of clinical records, risk factors for hospital death, and long-term survival was performed.
  
  
  RESULTS
  In-hospital mortality was 33.3%. The most common cause of hospital death was left-sided heart failure. A low ejection fraction and short time interval from acute myocardial infarction to the onset of VSP were significant risk factors. The actuarial survival rates of in-hospital survivors at 5 and 10 years were 81.7% and 43.5%, respectively. There were 17 cardiac events among the survivors during the follow-up period. The most influential factor affecting long-term outcomes was the number of diseased coronary arteries.
  
  
  CONCLUSIONS
  The long-term survival outcome of VSP patients during the postoperative period was comparatively good, but the prognosis of VSP patients with multivessel disease was not satisfactory because of congestive heart failure or ventricular arrhythmia. We believe that postoperative medical treatment for preventing cardiac remodeling is important for improving long-term survival outcomes in such patients.
authors.affiliation: Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya-ku, Saitama, 330-8503, Japan. nogu1265@omiya.jichi.ac.jp
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Noguchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Naito
authors.forename: Kouichi
authors.initials: K
authors.lastname: Yuri
authors.forename: Hideo
authors.initials: H
authors.lastname: Adachi
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002317:Cardiovascular Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D020257:Ventricular Remodeling; D018658:Ventricular Septal Rupture / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*
chemical_list: D002317:Cardiovascular Agents