title: Long-term outcome after transcatheter closure of postinfarction ventricular septal rupture.
abstract: OBJECTIVE
  We report the long-term all-cause mortality and procedure-related complication rate following transcatheter closure of postinfarction ventricular septal rupture (VSR) in a single tertiary center.
  
  
  BACKGROUND
  VSR is an exceedingly serious and deathly complication to myocardial infarction. Surgical closure has previously been the treatment of choice, but in the last decade a transcatheter approach has gained ground. However, reports on long-term survival are still sparse and experience is often restricted to large tertiary centers with high flow of patients.
  
  
  METHODS
  From January 2000 to April 2013, 9 patients underwent transcatheter closure of a VSR at Aarhus University Hospital. Primary device closure was chosen mainly because of significant risk factors against surgery. Our major endpoints were 30-day, 1-year, and 5-year mortality and years of survival until time of evaluation.
  
  
  RESULTS
  Our cohort had a mean age of 75.1 ± 8.4 years, and the median time from VSR to closure was 16 days (2-346). The 30-day, 1-year, and 5-year mortality rates were 11.1%, 33.3%, and 62.5%, respectively. Mean time of postprocedural survival was 4.6 ± 4.4 years at the time of review. Three patients were still alive at the time of review, 1 with a shock-index <1 at the time of VSR closure.
  
  
  CONCLUSIONS
  As a single medium-sized tertiary center, we report lower short- and long-term mortality rates compared with most published data on outcome after surgical closure. Our results are comparable to the few previously published reports on transcatheter closure of postinfarction VSRs.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus N, Denmark.
authors.forename: Johan
authors.initials: J
authors.lastname: Heiberg
authors.forename: Vibeke Elisabeth
authors.initials: VE
authors.lastname: Hjortdal
authors.forename: Jens Erik
authors.initials: JE
authors.lastname: Nielsen-Kudsk
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D055989:Septal Occluder Device; D018658:Ventricular Septal Rupture / Q000209:etiology / Q000401:mortality / Q000601:surgery*