Purpose: To evaluate our results based on rapid closure of a postinfarction ventricular septal defect, myocardial revascularization and ventricular remodeling. Patients: Retrospective analysis of 54 consecutive patients (30 with a posterobasal and 24 with an antero-apical rupture) operated between 1979 and 1998. Twenty-five patients were in shock. Twenty-six patients had a coronary disease limited to the culprit artery, and 28 a multivessel disease. Results: Early mortality was 26% (21% during the last decade). Two patients died peroperatively and 12 postoperatively, mostly due to cardiac failure. Ten patients had a residual septal defect requiring reoperation in 5. Survival was 78, 65 and 40% at 1, 5 and 10 years, respectively. Three years after the operation, the great majority of patients (17 out of 18) were in NYHA class I or II. Conclusions: Although surgery is the only chance for most patients with postinfarction ventricular septal rupture, it carries a significant early mortality. Survival rate with a good quality of life can, however, be achieved in the majority of the patients.

Keywords:
Myocardial infarction, Ventricular septal defect, Cardiac remodeling, Coronary artery disease
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© 2001 S. Karger AG, Basel
2002
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