Survival analysis of interventional therapy for post-myocardial infarction ventricular septal rupture

JING Chi; ZHANG Qiong

doi:10.3969/j.issn.1672-5301.2024.09.013

Abstract：Objective This study analyzed and follow-up patients undergoing percutaneous interventional therapy for PMIVSR,aiming to provide a valuable reference for the management and treatment of patients with PMIVSR.Methods The patients who underwent percutaneous interventional ventricular septal closure for PMIVSR from 2016 to 2021 at Wuhan Asia Heart Hospital were included.The patients were divided into death and survival groups based on whether they died during their hospital stay.A systematic review and statistical analysis of the patient medical records were performed.Results 25 patients met the inclusion criteria and 22(88％)got successful occluder placement,with 4(18％)dead and 18(82％)alive.There were statistical differences in gender(100％vs.44.4％,P=0.049),perforation size[(1.6±0.3)cm vs.(1.0±0.3)cm,P=0.012]and length of stay[(15.8±5.0)d vs.(23.8±6.9)d,P=0.04]between the two groups.There were statistical differences in SBP(101±5.3 vs.115.0±14.0,P=0.005)and the preoperative IABP assistance time/preoperative stay(1.0 vs.0.6,P=0.039)which both two were the indicators reflecting the preoperative hemodynamics between the two groups.The time from perforation to closure was all 13 days(13.5 d vs.13.89 d).There were no new deaths during the follow-up period.Conclusions The PMIVSR is a fatal complication of myocardial infarction.Our data suggest that percutaneous interventional closure is an effective treatment when the patient meets the indications for the surgery.Excluding the influence of surgical timing,the severe preoperative hemodynamic damage and postoperative complications are the high risk factors for death after the surgery.The patients who survive to discharge would have a good prognosis in long-term follow-up.