The Journal of Practical Medicine ›› 2023, Vol. 39 ›› Issue (14): 1774-1778.doi: 10.3969/j.issn.1006⁃5725.2023.14.008

• Clinical Research • Previous Articles     Next Articles

Different surgical approaches to postinfarction ventricular septal rupture after acute myocardial infarction: surgical repair vs. transcatheter interventional closure 

WANG Zhenzhen,SUN Zirui,LIU Yuhao.    

  1. The First Affiliated Hospital of He′nan University,Kaifeng 475000,China 
  • Online:2023-07-25 Published:2023-07-25
  • Contact: LIU Yuhao E⁃mail:1430884014@qq.com

Abstract:

Objective To analyze the clinical features and prognosis of patients with post ⁃infarction ventricular septal rupture(PIVSR)undergoing surgical repair or transcatheter interventional closure. Methods The clinical data of 64 patients who were diagnosed with PIVSR at the Heart Center of Henan Provincial People′s Hospital from 2017 to 2020 were reviewed and analyzed. Those undergoing transcatheter interventional closure were assigned as intervention closure group(n = 50)and those undergoing surgical repair as surgical repair group(n = 14). The baseline data,preoperative,intraoperative,and postoperative results and follow⁃up results were analyzed and compared between the two groups. Results Compared with the surgical repair group,the interventional closure group had a larger number of females,smaller VSR diameter,less severity of disease,lower hospitalization cost, shorter operation time,shorter ICU stay time,and higher residual shunt rate. Follow⁃up results showed that there were no statistically significant differences in left ventricular diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),6 min walking test one and six 6 months after the operation and the follow⁃up survival rate(P > 0.05). The Cox regression analysis showed that the Killip classification of cardiac function(Class Ⅱ⁃Ⅳ)was a risk factor affecting the survival of the patients of the two groups. Conclusion PIVSR patients undergoing interventional closure have a good prognosis. After closure,the patients have little trauma,quick recovery,low hospitalization costs,and high long⁃term survival rate. As a minimally invasive and effective therapy,it is likely to become an alternative treatment. 

Key words: acute myocardial infarction, postinfarction ventricular septal rupture, surgical repair surgery, transcatheter interventional closure