Cargando…
Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction
Ventricular septal rupture (VSR) is an uncommon complication of myocardial infarction (MI). The mortality rate of VSR is high. The management of VSR is including the stabilization of the hemodynamic status and surgical closure of the rupture. In spite of the agreement of experts on the necessity of...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Saudi Heart Association
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640570/ https://www.ncbi.nlm.nih.gov/pubmed/33154931 http://dx.doi.org/10.37616/2212-5043.1120 |
_version_ | 1783605773762297856 |
---|---|
author | Shafiei, Ibrahim Jannati, Fatemeh Jannati, Mansour |
author_facet | Shafiei, Ibrahim Jannati, Fatemeh Jannati, Mansour |
author_sort | Shafiei, Ibrahim |
collection | PubMed |
description | Ventricular septal rupture (VSR) is an uncommon complication of myocardial infarction (MI). The mortality rate of VSR is high. The management of VSR is including the stabilization of the hemodynamic status and surgical closure of the rupture. In spite of the agreement of experts on the necessity of surgical repair, the timing of VSR repair management remains unclear. In this review article, we evaluate the optimal time repair of VSR. To collect the data, Pubmed, EMBASE, and Cochrane Central Registry databases were searched for potentially suitable studies. Search terms were including “Ventricular Septal Rupture”, “Myocardial Infarction”, “Timing”, and “MI”. According to the result of the studies, it seems that the time between VSR detection and its repair is a determining factor in the survival or mortality of patients in post-myocardial infraction VSR. Studies showed that earlier surgical repair in VSR increases the risk of mortality, because in the early phase after MI, infarcted myocardium is very fragile, and it is very difficult surgical repair and increases the risk of recurrent septal defects. The longer time is needed for the heart and different body systems to adapt to the hemodynamic results of the abrupt left to right shunt. It seems that the best time for the operation is after the maturation of VSR with scarring at the edges of the defect. Moreover, in a large number of patients, it is not possible to delay the operation since they are at risk of severe heart failure and organ dysfunction. In these cases operation immediately after diagnosis of VSR is recommended to prevent further hemodynamic deterioration. In hemodynamically compromised patients, it may be considered to use a ventricular assist device, requiring an intra-aortic balloon pump (IABP), or extracorporeal membrane oxygenation (ECMO) preoperative to postpone the operation which leads to higher survival in post-MI-VSD. |
format | Online Article Text |
id | pubmed-7640570 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Saudi Heart Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-76405702020-11-04 Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction Shafiei, Ibrahim Jannati, Fatemeh Jannati, Mansour J Saudi Heart Assoc Review Article Ventricular septal rupture (VSR) is an uncommon complication of myocardial infarction (MI). The mortality rate of VSR is high. The management of VSR is including the stabilization of the hemodynamic status and surgical closure of the rupture. In spite of the agreement of experts on the necessity of surgical repair, the timing of VSR repair management remains unclear. In this review article, we evaluate the optimal time repair of VSR. To collect the data, Pubmed, EMBASE, and Cochrane Central Registry databases were searched for potentially suitable studies. Search terms were including “Ventricular Septal Rupture”, “Myocardial Infarction”, “Timing”, and “MI”. According to the result of the studies, it seems that the time between VSR detection and its repair is a determining factor in the survival or mortality of patients in post-myocardial infraction VSR. Studies showed that earlier surgical repair in VSR increases the risk of mortality, because in the early phase after MI, infarcted myocardium is very fragile, and it is very difficult surgical repair and increases the risk of recurrent septal defects. The longer time is needed for the heart and different body systems to adapt to the hemodynamic results of the abrupt left to right shunt. It seems that the best time for the operation is after the maturation of VSR with scarring at the edges of the defect. Moreover, in a large number of patients, it is not possible to delay the operation since they are at risk of severe heart failure and organ dysfunction. In these cases operation immediately after diagnosis of VSR is recommended to prevent further hemodynamic deterioration. In hemodynamically compromised patients, it may be considered to use a ventricular assist device, requiring an intra-aortic balloon pump (IABP), or extracorporeal membrane oxygenation (ECMO) preoperative to postpone the operation which leads to higher survival in post-MI-VSD. Saudi Heart Association 2020-07-31 /pmc/articles/PMC7640570/ /pubmed/33154931 http://dx.doi.org/10.37616/2212-5043.1120 Text en © 2020 Saudi Heart Association This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Review Article Shafiei, Ibrahim Jannati, Fatemeh Jannati, Mansour Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction |
title | Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction |
title_full | Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction |
title_fullStr | Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction |
title_full_unstemmed | Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction |
title_short | Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction |
title_sort | optimal time repair of ventricular septal rupture post myocardial infarction |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640570/ https://www.ncbi.nlm.nih.gov/pubmed/33154931 http://dx.doi.org/10.37616/2212-5043.1120 |
work_keys_str_mv | AT shafieiibrahim optimaltimerepairofventricularseptalrupturepostmyocardialinfarction AT jannatifatemeh optimaltimerepairofventricularseptalrupturepostmyocardialinfarction AT jannatimansour optimaltimerepairofventricularseptalrupturepostmyocardialinfarction |