Ventricular Septal Rupture Management in Patients With Acute Myocardial Infarction: A Review.

Autor:	Tripathi A; Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad, IND., Bisht H; Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad, IND., Arya A; Internal Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad, IND., Konat A; Department of Zoology, Biomedical Technology and Human Genetics, Gujarat University, Ahmedabad, IND., Patel D; Internal Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad, IND., Patel J; Internal Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad, IND., Godhani D; Trauma and Orthopaedics, Gujarat Medical Education and Research Society Medical College, Gandhinagar, IND., Mozumder K; Internal Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad, IND., Parikh D; Internal Medicine, Gujarat Medical Education and Research Society Medical College, Gandhinagar, IND., Jain P; Internal Medicine, Smt Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND., Sharma K; Cardiology, Dr. Kamal Sharma Cardiology Clinic, Ahmedabad, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Jun 13; Vol. 15 (6), pp. e40390. Date of Electronic Publication: 2023 Jun 13 (Print Publication: 2023).
DOI:	10.7759/cureus.40390
Abstrakt:	Untreated myocardial infarction (MI) can potentially lead to many fatal complications which require immediate management. One of them is ventricular septal rupture (VSR) which necessitates the hemodynamic stabilization and closure of the septal rupture. Conventional treatment strategy involves surgical repair; however, percutaneous transcatheter repair using an occluder device is a promising upcoming approach. We conducted a detailed review of various published articles and examined the trends in incidence, risk factors, and pathophysiology of MI leading to VSR followed by an in-depth analysis of the various management strategies for the same. In the current clinical scenario, thrombolysis is an imperative management strategy that has been shown to decrease the occurrence of VSR by manifolds, more specifically in patients having ST-elevated MI. Delayed surgical closure remains the main treatment for post-infarction VSR. Other newer modalities, such as percutaneous closure devices and mechanical circulatory supports, are attractive alternative or complementary strategies to treat such patients, both postoperatively and perioperatively. However, earlier surgical repair in VSR increases the risk of mortality, and the optimal timing for VSR closure remains controversial. Despite surgical closure of VSR being the traditional treatment, it presents a considerably high operative risk. Although newer interventions such as percutaneous closure devices and mechanical circulatory supports provide impressive outcomes, their efficacy in high-risk patients remains inconclusive. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Tripathi et al.)
Databáze:	MEDLINE
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