Research progress on diagnosis and treatment of ventricular septal rupture after acute myocardial infarction
Cheng Sihao
Liu Nan
Abstract：Post-infarction ventricular septal rupture(PIVSR)is a rare but fatal mechanical complication of acute myocardial infarction(AMI).In the reperfusion era,its incidence has decreased to below 1％,yet once it occurs,the mortality rate remains extremely high(ranging from 40％to 90％).The core pathophysiology is the rupture of the transmural infarct zone,leading to left-to-right shunt and rapid hemodynamic deterioration.The clinical manifestation is mostly sudden exacerbation of the condition after AMI,accompanied by a new-onset cardiac murmur,and bedside echocardiography is the preferred diagnostic method.Treatment requires multidisciplinary collaboration,with individualized selection of medications,mechanical circulatory support(such as intra-aortic balloon pump,extracorporeal membrane oxygenation),and ultimately surgical repair or transcatheter closure as the definitive treatments.The timing of surgery is controversial and requires balancing hemodynamic stability and the degree of tissue fibrosis.The prognosis is extremely poor,affected by multiple factors such as advanced age,cardiogenic shock,rupture location and surgical timing.This paper summarizes and discusses the epidemiology,pathophysiology,diagnosis,treatment and prognosis of PIVSR to guide clinical practice.
Keywords：Post-infarction ventricular septal ruptureMechanical circulatory supportTranscatheter closureSurgical repairTiming of surgeryPrognostic factors
Publication Date：2026-03-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 438-442 )