BACKGROUND: No consistent data are available on the specific coronary artery pathology leading to postinfarction ventricular septal rupture. The benefits and risks of coronary angiography and subsequent coronary artery bypass grafting in these patients is under discussion. METHODS: Clinical and coronary angiographic factors were analysed in 109 consecutive patients treated surgically for postinfarction ventricular septal rupture between 1980 and 1992. Coronary angiography was performed in 104 patients, and 92 of the angiograms were available for complete analysis. Factors were related to late cardiac mortality in 79 patients surviving the early period. RESULTS: Single-vessel disease was found in 58 patients (55.8%) and multiple-vessel in 46 (44.2%). In 24 patients (26.1%) there was some collateral circulation to the infarct-related coronary artery. No relationship was found between dominance, occlusion location and early or late outcome. Forty-five patients (41.3%) underwent coronary revascularization in addition to surgical closure of the ventricular septal rupture. Risk factors for late cardiac mortality in patients surviving the early postoperative period were postoperative cardiac failure (P = 0.0089), incomplete coronary revascularization (P = 0.024) and longer aortic cross-clamp time (P = 0.032). CONCLUSION: We conclude that concomitant complete revascularization is indicated during surgical repair of postinfarction ventricular septal rupture.
BACKGROUND: No consistent data are available on the specific coronary artery pathology leading to postinfarction ventricular septal rupture. The benefits and risks of coronary angiography and subsequent coronary artery bypass grafting in these patients is under discussion. METHODS: Clinical and coronary angiographic factors were analysed in 109 consecutive patients treated surgically for postinfarction ventricular septal rupture between 1980 and 1992. Coronary angiography was performed in 104 patients, and 92 of the angiograms were available for complete analysis. Factors were related to late cardiac mortality in 79 patients surviving the early period. RESULTS: Single-vessel disease was found in 58 patients (55.8%) and multiple-vessel in 46 (44.2%). In 24 patients (26.1%) there was some collateral circulation to the infarct-related coronary artery. No relationship was found between dominance, occlusion location and early or late outcome. Forty-five patients (41.3%) underwent coronary revascularization in addition to surgical closure of the ventricular septal rupture. Risk factors for late cardiac mortality in patients surviving the early postoperative period were postoperative cardiac failure (P = 0.0089), incomplete coronary revascularization (P = 0.024) and longer aortic cross-clamp time (P = 0.032). CONCLUSION: We conclude that concomitant complete revascularization is indicated during surgical repair of postinfarction ventricular septal rupture.
Authors: Santanu Guha; Rishi Sethi; Saumitra Ray; Vinay K Bahl; S Shanmugasundaram; Prafula Kerkar; Sivasubramanian Ramakrishnan; Rakesh Yadav; Gaurav Chaudhary; Aditya Kapoor; Ajay Mahajan; Ajay Kumar Sinha; Ajit Mullasari; Akshyaya Pradhan; Amal Kumar Banerjee; B P Singh; J Balachander; Brian Pinto; C N Manjunath; Chandrashekhar Makhale; Debabrata Roy; Dhiman Kahali; Geevar Zachariah; G S Wander; H C Kalita; H K Chopra; A Jabir; JagMohan Tharakan; Justin Paul; K Venogopal; K B Baksi; Kajal Ganguly; Kewal C Goswami; M Somasundaram; M K Chhetri; M S Hiremath; M S Ravi; Mrinal Kanti Das; N N Khanna; P B Jayagopal; P K Asokan; P K Deb; P P Mohanan; Praveen Chandra; Col R Girish; O Rabindra Nath; Rakesh Gupta; C Raghu; Sameer Dani; Sandeep Bansal; Sanjay Tyagi; Satyanarayan Routray; Satyendra Tewari; Sarat Chandra; Shishu Shankar Mishra; Sibananda Datta; S S Chaterjee; Soumitra Kumar; Soura Mookerjee; Suma M Victor; Sundeep Mishra; Thomas Alexander; Umesh Chandra Samal; Vijay Trehan Journal: Indian Heart J Date: 2017-03-23
Authors: Philip Y K Pang; Yoong Kong Sin; Chong Hee Lim; Teing Ee Tan; See Lim Lim; Victor T T Chao; Jang Wen Su; Yeow Leng Chua Journal: J Cardiothorac Surg Date: 2013-03-09 Impact factor: 1.637