PMID- 1482822
OWN - NLM
STAT- MEDLINE
DCOM- 19930217
LR  - 20190918
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 7
IP  - 4
DP  - 1992 Dec
TI  - Survival after repair of postinfarction ventricular septal defects in patients 
      over the age of 70.
PG  - 290-300
AB  - Ventricular septal defect (VSD) is an infrequent but extremely serious 
      complication of myocardial infarction. Operative mortality rates tend to be 
      higher in the elderly population; however, long-term follow-up has not been 
      specifically studied. It is, therefore, important to assess not only the early 
      but also the long-term results of VSD repair in patients over 70 years of age to 
      determine its value for the elderly patient. Between June 1968 and May 1991, 86 
      patients who experienced a myocardial infarction underwent surgical repair of an 
      infarct related VSD at the Massachusetts General Hospital (MGH). Group I (n = 57) 
      includes those patients younger than 70 years, and group II (n = 29) represents 
      those patients age 70 years and older. Follow-up of hospital survivors ranged 
      from 1 month to 24 years and was compiled in April and May, 1991. Three patients 
      were lost to follow-up (4%), and these were younger than 70 years of age. There 
      were no differences in the values of the preoperative variables for the younger 
      and older groups with respect to sex, concomitant procedures performed (bypass vs 
      no bypass), use of an intra-aortic balloon pump (IABP), location of VSD, presence 
      of shock, total hospital days, or days between infarction and operation. There 
      was, however, a difference between the two groups relative to the era when 
      surgery was performed. More patients over the age of 70 underwent surgery after 
      1978 than before 1978 (p = 0.0012). The majority of survivors are in New York 
      Heart Association (NYHA) Class I or II, and there was no difference between the 
      younger and older groups in functional class at the time of follow-up (83.3% vs 
      91.7% of survivors in Class I or II, respectively). Using the generalized 
      Wilcoxon test to analyze these survival data, there was no apparent difference in 
      long-term survival (p = 0.97) when comparing the two age groups. The mean 
      follow-up period was 77.02 months for the younger group and 80.52 months for the 
      older group. The fact that more older patients were repaired after we had 
      significant experience in the surgical management of patients with VSDs probably 
      accounted for our excellent results in the older age group. Our data reveal that 
      patients over the age of 70 can expect excellent long-term survival, with over 
      90% of these survivors remaining in NYHA Functional Class I or II.
FAU - Muehrcke, D D
AU  - Muehrcke DD
AD  - Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 
      Boston 02114.
FAU - Blank, S
AU  - Blank S
FAU - Daggett, W M
AU  - Daggett WM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Surgical Procedures/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Rupture, Post-Infarction/*mortality/surgery
MH  - Heart Septum/*surgery
MH  - Heart Ventricles/surgery
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/mortality
MH  - Survival Analysis
EDAT- 1992/12/01 00:00
MHDA- 1992/12/01 00:01
CRDT- 1992/12/01 00:00
PHST- 1992/12/01 00:00 [pubmed]
PHST- 1992/12/01 00:01 [medline]
PHST- 1992/12/01 00:00 [entrez]
AID - 10.1111/j.1540-8191.1992.tb01019.x [doi]
PST - ppublish
SO  - J Card Surg. 1992 Dec;7(4):290-300. doi: 10.1111/j.1540-8191.1992.tb01019.x.