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Management of post‐myocardial infarction ventricular septal defects: A critical assessment

Omar, Sabry ; Morgan, Garrison L. ; Panchal, Hemang B. ; Thourani, Vinod ; Rihal, Charanjit S. ; Patel, Ruchi ; Kherada, Nisharahmed ; Egbe, Alexander C. ; Beohar, Nirat

Journal of interventional cardiology, 2018-12, Vol.31 (6), p.939-948 [Periódico revisado por pares]

United States: Hindawi Limited

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Título:
Management of post‐myocardial infarction ventricular septal defects: A critical assessment
Autor: Omar, Sabry ; Morgan, Garrison L. ; Panchal, Hemang B. ; Thourani, Vinod ; Rihal, Charanjit S. ; Patel, Ruchi ; Kherada, Nisharahmed ; Egbe, Alexander C. ; Beohar, Nirat
Assuntos: Adult ; Aged ; Cardiac Surgical Procedures - statistics & numerical data ; closure device ; Heart attacks ; Heart Septal Defects, Ventricular - etiology ; Heart Septal Defects, Ventricular - mortality ; Heart Septal Defects, Ventricular - therapy ; Humans ; management ; Middle Aged ; Mortality ; Myocardial infarction ; Myocardial Infarction - complications ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Patients ; post‐infarction VSD ; Septal Occluder Device - statistics & numerical data ; Surgery ; Survival Rate ; transcatheter ; Treatment Outcome ; Ventricle
É parte de: Journal of interventional cardiology, 2018-12, Vol.31 (6), p.939-948
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
ObjectType-Review-1
Descrição: Background Post‐myocardial infarction (MI) ventricular septal defects (PIVSD) are an uncommon but life‐threatening complication of acute MI. Although surgical closure has been the standard of care, mortality, and recurrence of VSD remain high even after emergent surgery. Transcatheter VSD closure (TCC) devices have become an alternative or adjunct to surgical closure. Methods Online database search was performed for studies that included adults with PIVSD who underwent medical treatment (MT) alone, surgical closure (SC) (early or late), and TCC (early, late, or for post‐surgical residual VSD). Results Twenty‐six studies were included with a total of 737 patients who underwent either MT (N = 100), SC (early (n = 167), late (n = 100)), and TCC (early (n = 176), late (n = 115), or post‐surgical residual VSD (n = 79)). The 30‐day mortality among MT group was 92 ± 6.3%, among SC was 61 ± 22.5% (early 56 ± 23%, late 41 ± 30%), and for all TCC patients was 33 ± 24% (early 54 ± 32.7%, late 16 ± 26%), and TCC for post‐surgical residual VSD 11 ± 34.9%. The mortality among overall SC, overall TCC and early TCC groups was significantly lower as compared with the MT (P < 0.001 for all comparisons). The overall mortality among all TCC, and late TCC groups was significantly lower when compared with the late SC (P < 0.0001, P < 0.0001, respectively). Conclusion Closure of PIVSD decreases mortality as compared with MT alone and should be attempted as early as possible after diagnosis. Selection of TCC versus SC should be based on factors including complexity of the defect, availability of closure devices, expertise of the operator, and clinical condition of patient.
Editor: United States: Hindawi Limited
Idioma: Inglês

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Management of post‐myocardial infarction ventricular septal defects: A critical assessment

Omar, Sabry ; Morgan, Garrison L. ; Panchal, Hemang B. ; Thourani, Vinod ; Rihal, Charanjit S. ; Patel, Ruchi ; Kherada, Nisharahmed ; Egbe, Alexander C. ; Beohar, Nirat

United States: Hindawi Limited

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