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Revista chilena de cardiología

versión On-line ISSN 0718-8560

Resumen

MUNOZ, Cecilia et al. Surgery for post infarction ventricular septal defect: a 22-year experience. Rev Chil Cardiol [online]. 2014, vol.33, n.2, pp.87-94. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602014000200001.

Background: The development of a ventricular septal defect (VSD) after myocardial infarction is a rare but very serious complication for which the treatment of choice is surgical repair. Aim: To report our results with patients operated on for post-infarction VSD in the last 22 years. Methods: This is a retrospective review of all patients operated for post infarction VSD between january 1991 and december 2012. We reviewed all clinical charts and operative notes. Longterm mortality was certified by the "Registro Civil e Identificación de Chile". Results: Fourty three patients with a mean age of 66.6 ± 10.2 years underwent surgical repair. Fifty eight percent were males. The average time between myocardial infarction and the diagnosis of vsd was 10 ± 15.2 days. Seventy four percent of patients were operated on as an emergency. In 58% of cases the VSD was located in the anterior septum. Myocardial revascularization was performed in 58%. Thirteen patients died for an operative mortality of 30%. Risk factors for operative mortality were emergency surgery (p = 0,04) and the use of intraaortic balloon pump (p = 0,004). Non emergency surgery had a much lower mortality rate ( 7,7%, p = 0,033). Survival excluding operative mortality at 5 and 10 years was 90% and 71%, respectively. Conclusions: Operative mortality for repair of post infarction VSD remains high, mainly in patients undergoing an emergency operation. Surgical survivors have a very good life expectancy.

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