Outcomes of Early Versus Delayed Transcatheter Closure of Post-Myocardial Infarction Ventricular Septal Defect
| Autor: | Manyoo Agarwal, Mark Heckle, Jeremy A. Brooksbank, Uzoma N. Ibebuogu |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Heart Septal Defects
Ventricular Cardiac Catheterization congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty 030204 cardiovascular system & hematology Post myocardial infarction 03 medical and health sciences 0302 clinical medicine Humans Medicine In patient 030212 general & internal medicine Myocardial infarction Survival rate Anterior Wall Myocardial Infarction Surgical repair business.industry High mortality General Medicine medicine.disease Surgery Delayed repair Treatment Outcome Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | Cardiovascular Revascularization Medicine. 21:1093-1096 |
| ISSN: | 1553-8389 |
| DOI: | 10.1016/j.carrev.2020.02.011 |
| Popis: | Post myocardial infarction ventricular septal defect (VSD) is a rare, but devastating complication which carries a poor prognosis if left untreated. Optimal therapy remains unclear and surgical repair is associated with high mortality.The aim of our study is to compare 30-day survival in patients with early versus late primary transcatheter repair of post myocardial infarction ventricular septal defect.We performed a comprehensive search of published data through SCOPUS and identified published reports of primary transcatheter closure of post myocardial infarction VSD. We included case reports and series that reported timing of VSD closure and 30-day survival and excluded those with prior surgical repair. Early repair was defined as transcatheter closure within 14 days of diagnosis of VSD while late repair was defined as transcatheter closure after 14 days of diagnosis of VSD.A total 27 publications describing 193 patients were identified in the SCOPUS search. We excluded 8 publications with no reported timing of VSD repair or 30-day outcome. Of the 193 patients initially included, a total of 126 patients fulfilled all the criteria and were included in the final analysis. The overall 30-day survival rate was found to be 62.7% (79 patients). In the early repair group, only 36.2% of the patients were still alive at 30 days compared to 85.3% in the delayed repair group, P .01. No significant difference in age, gender, presence of shock, VSD size, presence of significant residual shunt, location of VSD or infarction was observed. The early repair group was found to have a significantly larger Qp: Qs ratio as well as larger occluder size and lower rate of successful repair.Compared to the late repair group, the early transcatheter VSD repair group had a larger pre-procedure Qp:Qs and worse 30-day survival. Further studies are needed to determine the optimal timing of transcatheter repair of a post myocardial infarction VSD. |
| Databáze: | OpenAIRE |
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