Matteo Matteucci1,2, Daniele Ronco1,2, Justine M Ravaux1, Giulio Massimi1,2, Michele Di Mauro1, Saskia Houterman3, Jos Maessen1,4, Cesare Beghi2, Paolo Severgnini5, Roberto Lorusso1,4. 1. Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands. 2. Department of Surgical and Morphological Sciences, Circolo Hospital, University of Insubria, Varese, Italy. 3. Netherlands Heart Registration, Utrecht, The Netherlands. 4. Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands. 5. Department of Biotechnology and Sciences of Life, University of Insubria, Varese, Italy.
Abstract
Background: Ventricular free-wall rupture (VFWR) is an infrequent but catastrophic complication of acute myocardial infarction (AMI). Most reports about outcome after surgical treatment are single-center experiences. We examined the early and mid-term outcomes after surgical repair of post-AMI VFWR using the Netherlands Heart Registration (NHR) database. Methods: We included data from NHR patients (>18 years old) who underwent surgery for post-AMI VFWR between 2014 and 2019. The primary end-point was in-hospital mortality. Secondary outcomes included postoperative complications and mid-term survival. Results: The study included 148 patients (54.7% male, mean age 66.5±11.1 years). Critical preoperative status was found in 62.6% of subjects. In-hospital mortality was 31.1% (46 of 148). Multivariable analysis identified female sex [odds ratio (OR), 5.49; 95% confidence interval (CI): 2.24-13.46] and critical preoperative status (OR, 4.06; 95% CI: 1.36-12.13) as independent predictors of in-hospital mortality. The overall median postoperative follow-up was 2.2 (interquartile range, 0.7-3.8) years. Overall survival rates at three and five years were 58.9% and 55.7%, respectively. Among hospital survivors, only 15 (14.7%) patients died during follow-up, with a five-year survival rate of 80.8%. Conclusions: In-hospital mortality after surgical repair of post-AMI VFWR is considerable. Female sex and preoperative critical status are independent predictors of early postoperative (in-hospital) death. Logistic EuroSCORE I can reliably predict in-hospital mortality (optimal cut-off >33%). Mid-term follow-up of patients surviving in-hospital course shows excellent results. 2022 Annals of Cardiothoracic Surgery. All rights reserved.
Background: Ventricular free-wall rupture (VFWR) is an infrequent but catastrophic complication of acute myocardial infarction (AMI). Most reports about outcome after surgical treatment are single-center experiences. We examined the early and mid-term outcomes after surgical repair of post-AMI VFWR using the Netherlands Heart Registration (NHR) database. Methods: We included data from NHR patients (>18 years old) who underwent surgery for post-AMI VFWR between 2014 and 2019. The primary end-point was in-hospital mortality. Secondary outcomes included postoperative complications and mid-term survival. Results: The study included 148 patients (54.7% male, mean age 66.5±11.1 years). Critical preoperative status was found in 62.6% of subjects. In-hospital mortality was 31.1% (46 of 148). Multivariable analysis identified female sex [odds ratio (OR), 5.49; 95% confidence interval (CI): 2.24-13.46] and critical preoperative status (OR, 4.06; 95% CI: 1.36-12.13) as independent predictors of in-hospital mortality. The overall median postoperative follow-up was 2.2 (interquartile range, 0.7-3.8) years. Overall survival rates at three and five years were 58.9% and 55.7%, respectively. Among hospital survivors, only 15 (14.7%) patients died during follow-up, with a five-year survival rate of 80.8%. Conclusions: In-hospital mortality after surgical repair of post-AMI VFWR is considerable. Female sex and preoperative critical status are independent predictors of early postoperative (in-hospital) death. Logistic EuroSCORE I can reliably predict in-hospital mortality (optimal cut-off >33%). Mid-term follow-up of patients surviving in-hospital course shows excellent results. 2022 Annals of Cardiothoracic Surgery. All rights reserved.
Authors: Patrick Sulzgruber; Feras El-Hamid; Lorenz Koller; Stefan Forster; Georg Goliasch; Johann Wojta; Alexander Niessner Journal: Int J Cardiol Date: 2016-11-07 Impact factor: 4.164
Authors: Matteo Matteucci; Mariusz Kowalewski; Michele De Bonis; Francesco Formica; Federica Jiritano; Dario Fina; Paolo Meani; Thierry Folliguet; Nikolaos Bonaros; Sandro Sponga; Piotr Suwalski; Andrea De Martino; Theodor Fischlein; Giovanni Troise; Guglielmo Actis Dato; Giuseppe Filiberto Serraino; Shabir Hussain Shah; Roberto Scrofani; Carlo Antona; Antonio Fiore; Jurij Matija Kalisnik; Stefano D'Alessandro; Emmanuel Villa; Vittoria Lodo; Andrea Colli; Ibrahim Aldobayyan; Giulio Massimi; Cinzia Trumello; Cesare Beghi; Roberto Lorusso Journal: Ann Thorac Surg Date: 2020-12-09 Impact factor: 4.330