title: Early Mortality and Long-term Survival after Repair of Post-infarction Ventricular Septal Rupture: An Institutional Report of Experience.
abstract: BACKGROUND
  To determine predictors of mortality after surgical management of post-infarction ventricular septal rupture repair.
  
  
  METHODS
  A total of 63 patients (73.2%, mean age 67.22±7.71 years, male:female ratio; 35:28) underwent open heart surgery for post-infarction ventricular septal rupture repair. Patient demographics, operative data and postoperative parameters were analysed to reveal predictors of early mortality and long-term survival.
  
  
  RESULTS
  In-hospital mortality was 54.0% (34/63). Time from myocardial infarction to operation ≤ 14 days (OR: 4.10, 95% CI 1.16-14.46, p=0.02), systolic pulmonary artery pressure > 45 mmHg (OR: 4.14, 95% CI 1.110-15.496, p=0.03) and age (years) (OR: 1.09, 95% CI 1.002-1.194, p=0.04) were found to be independent predictors of in-hospital mortality. In multivariate Cox regression analysis, presence of pulmonary oedema on admission (HR: 4.95, 95% CI 1.58-15.54, p=0.006), age (years) (HR: 1.09, 95% CI 1.009-1.180, p= 0.02) and cross-clamp time <60 min (HR: 3.93, 95% CI 1.13-13.64, p=0.03) were found to be independent predictors of long-term survival. Within a follow-up of a median of 60.0 months, five-year survival rate was 67±9.0%.
  
  
  CONCLUSIONS
  In line with the previous studies, our study demonstrated the benefits of delaying the repair for post-infarction ventricular septal rupture to allow adequate myocardial healing if haemodynamic status of the patient allows.
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, 06230, Ankara, Turkey. Electronic address: adnanyalcinkaya@gmail.com.
authors.forename: Adnan
authors.initials: A
authors.lastname: Yalçınkaya
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, 06230, Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Lafçı
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, 06230, Ankara, Turkey.
authors.forename: Adem İlkay
authors.initials: Aİ
authors.lastname: Diken
authors.affiliation: Kartal Kosuyolu Education and Research Hospital, Department of Cardiovascular Surgery, 34873, Istanbul, Turkey.
authors.forename: Eray
authors.initials: E
authors.lastname: Aksoy
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, 06230, Ankara, Turkey.
authors.forename: Ömer Faruk
authors.initials: ÖF
authors.lastname: Çiçek
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Anesthesiology 06230, Ankara, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Lafçı
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Cardiovascular Surgery, 06230, Ankara, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Korkmaz
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, 06230, Ankara, Turkey.
authors.forename: Kerim
authors.initials: K
authors.lastname: Çağlı
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors; D018658:Ventricular Septal Rupture / Q000209:etiology / Q000401:mortality / Q000503:physiopathology
keywords: Myocardial infarction; Survival; Ventricular septal rupture