Good long-term outcome following surgical repair of post-infarction ventricular septal defect

Aust N Z J Med. 1995 Aug;25(4):330-6. doi: 10.1111/j.1445-5994.1995.tb01898.x.

Abstract

Background: A post-infarction ventricular septal defect (VSD) is a serious complication of a myocardial infarction with 90% of patients dying by two months, in published series. Urgent surgical repair improves the prognosis.

Aims: To assess the Green Lane Hospital experience over a ten year period, especially with regard to hospital mortality and long-term follow up.

Methods: A retrospective case note review of all 35 consecutive patients undergoing post-infarct VSD repair from 1981 to 1990. Long-term follow up was obtained in all but one patient (97%).

Results: Twenty-one male and 14 female patients presented with a mean age of 67 years (range 51-75). All were in NYHA class 3 or 4, 14 (40%) were in cardiogenic shock. Following urgent surgical repair, 30 day mortality was 31% (11 patients). A further three patients died at two, 33 and 39 months; one patient was lost to follow up. At a mean follow up of 61 months (range 16-111), 15 patients were in NYHA class 1 or 2, five in NYHA class 3 or 4. For the whole group (n = 35) the actuarial survival was 66% at one year, 62% at three years and 58% at nine years.

Conclusion: Post-infarct VSD surgery is of major prognostic benefit with patients obtaining a good long-term outcome.

MeSH terms

  • Aged
  • Coronary Artery Bypass
  • Female
  • Heart Septal Defects, Ventricular / etiology*
  • Heart Septal Defects, Ventricular / mortality
  • Heart Septal Defects, Ventricular / surgery*
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Retrospective Studies
  • Treatment Outcome