PMID- 10746417
OWN - NLM
STAT- MEDLINE
DCOM- 20000427
LR  - 20041117
IS  - 0578-1337 (Print)
IS  - 0578-1337 (Linking)
VI  - 63
IP  - 3
DP  - 2000 Mar
TI  - Surgical repair of postinfarction ventricular septal defect.
PG  - 213-9
AB  - BACKGROUND: Rupture of the interventricular septum complicates 1% to 2% of all 
      acute myocardial infarction patients and its natural course is ominous. The 
      purpose of this study is to present our experience with surgical ventricular 
      septal defect (VSD) repair and examine the possible risk factors and explanations 
      for surgical mortality. METHODS: Fourteen patients underwent repair of 
      postinfarction VSD from 1996 to 1998 at the Taipei Veterans General Hospital. 
      Thirteen patients were in New York Heart Association (NYHA) Functional Class IV 
      and one was in Functional Class III. Eleven patients were in cardiogenic shock 
      with intra-aortic balloon pumps (IABPs) prior to surgery. The operative 
      techniques for VSD repair range from extensive infarctectomy with reconstruction 
      of the septum and the right and left ventricular free walls using single or 
      double patches, to minimal or no infarctectomy with closure of the VSD by 
      excluding the infarcted muscle from the left ventricular cavity and leaving the 
      right ventricle intact. RESULTS: Overall surgical mortality occurred in four 
      patients. All deaths occurred in patients with cardiogenic shock, two with 
      anterior VSD and two with posterior VSD. Three late survivors had limited 
      exercise tolerance with NYHA Functional Class II to III. Left ventricular 
      function was moderately impaired in most patients with a mean nuclear scan 
      ejection fraction of 0.32. However, all patients were elderly and adapted to 
      their residual symptoms without significant life-style changes. CONCLUSIONS: The 
      surgical mortality for treating patients with postinfarction VSD has decreased 
      with improvements in surgical technique. Rapid diagnosis, appropriate 
      preoperative management and delicate surgical repair improve the overall results 
      and help to attain long-term survival.
FAU - Wang, J S
AU  - Wang JS
AD  - Department of Surgery, Taipei Veterans General Hospital, Taiwan, ROC.
FAU - Hsu, C P
AU  - Hsu CP
FAU - Yu, T J
AU  - Yu TJ
FAU - Hwang, J S
AU  - Hwang JS
FAU - Shiu, C T
AU  - Shiu CT
FAU - Lai, S T
AU  - Lai ST
LA  - eng
PT  - Journal Article
PL  - China (Republic : 1949- )
TA  - Zhonghua Yi Xue Za Zhi (Taipei)
JT  - Zhonghua yi xue za zhi = Chinese medical journal; Free China ed
JID - 0005327
SB  - IM
MH  - Aged
MH  - Cardiomyopathies/*surgery
MH  - Female
MH  - Heart Septum/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications
MH  - Postoperative Complications
EDAT- 2000/04/04 09:00
MHDA- 2000/04/29 09:00
CRDT- 2000/04/04 09:00
PHST- 2000/04/04 09:00 [pubmed]
PHST- 2000/04/29 09:00 [medline]
PHST- 2000/04/04 09:00 [entrez]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi (Taipei). 2000 Mar;63(3):213-9.