title: Survival after surgical repair of ischemic ventricular septal rupture.
abstract: OBJECTIVE
  We reviewed our results and experience over a 14-year period to identify predictors of outcome following surgical repair of postinfarction ventricular septal rupture.
  
  
  METHODS
  A retrospective review was carried over a 14-year period. All patients had surgical repair of a postinfarction ventricular septal rupture. Patient demographics, perioperative variables, and survival data were collected. Logistic regression identified independent predictors of 30-day mortality. Multivariate analysis determined the effects of independent risk factors on survival.
  
  
  RESULTS
  Surgery for postinfarction ventricular septal rupture was carried out on 59 patients. The median age was 69 years, and 69% were male. In 54% of patients, the ventricular septal rupture was anterior, and 75% had concomitant coronary artery bypass grafting. Mortality was 39% at 30 days. Age was the most important predictor of 30-day and long-term outcome. Logistic regression analysis identified age, preoperative ventilation, and female sex as significant predictors of 30-day mortality. Cardiogenic shock, preoperative ventilation, and advanced age were associated with reduced medium-term survival. Surprisingly, anterior ventricular septal rupture was associated with reduced long-term survival. Concomitant coronary artery bypass grafting did not influence 30-day or long-term outcome.
  
  
  CONCLUSIONS
  Despite advances, the surgical mortality from ventricular septal rupture remains high. Age remains the most important predictor of outcome, and concomitant coronary artery bypass grafting does not appear to have a demonstrable benefit. Interestingly, anterior ventricular septal rupture had poorer long-term outcome than inferior ventricular septal rupture.
authors.affiliation: Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge CB23 3RE, UK.
authors.forename: Yasir
authors.initials: Y
authors.lastname: Abu-Omar
authors.forename: Peter
authors.initials: P
authors.lastname: Bhinda
authors.forename: Cliff K C
authors.initials: CK
authors.lastname: Choong
authors.forename: Samer A M
authors.initials: SA
authors.lastname: Nashef
authors.forename: Sukumaran
authors.initials: S
authors.lastname: Nair
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D017202:Myocardial Ischemia / Q000150:complications; D012189:Retrospective Studies; D015996:Survival Rate; D018658:Ventricular Septal Rupture / Q000209:etiology / Q000401:mortality* / Q000601:surgery*