Ventricular septal rupture (VSR) is an uncommon complication of myocardial infarction (MI). The mortality rate of VSR is high. The management of VSR is including the stabilization of the hemodynamic status and surgical closure of the rupture. In spite of the agreement of experts on the necessity of surgical repair, the timing of VSR repair management remains unclear. In this review article, we evaluate the optimal time repair of VSR. To collect the data, Pubmed, EMBASE, and Cochrane Central Registry databases were searched for potentially suitable studies. Search terms were including “Ventricular Septal Rupture”, “Myocardial Infarction”, “Timing”, and “MI”. According to the result of the studies, it seems that the time between VSR detection and its repair is a determining factor in the survival or mortality of patients in post-myocardial infraction VSR. Studies showed that earlier surgical repair in VSR increases the risk of mortality, because in the early phase after MI, infarcted myocardium is very fragile, and it is very difficult surgical repair and increases the risk of recurrent septal defects. The longer time is needed for the heart and different body systems to adapt to the hemodynamic results of the abrupt left to right shunt. It seems that the best time for the operation is after the maturation of VSR with scarring at the edges of the defect. Moreover, in a large number of patients, it is not possible to delay the operation since they are at risk of severe heart failure and organ dysfunction. In these cases operation immediately after diagnosis of VSR is recommended to prevent further hemodynamic deterioration. In hemodynamically compromised patients, it may be considered to use a ventricular assist device, requiring an intra-aortic balloon pump (IABP), or extracorporeal membrane oxygenation (ECMO) preoperative to postpone the operation which leads to higher survival in post-MI-VSD.
at Room Temperature. -The method tolerates different functional groups at the aromatic rings; no reaction is observed for aliphatic aldehydes. In some cases, low amounts of benzimidazoles are observed as by-products. -(OSKOOIE, H. A.; HERAVI*, M. M.; SADNIA, A.; BEHBAHANI, F. K.; JANNATI, F.; Chin.
Nitriles Q 0520 H2SO4/Silicagel: Highly Efficient Catalyst for the Synthesis of α-Aminonitriles Using Trimethylsilyl Cyanide. -A simple, convenient, and practical method for the synthesis of title compounds (IV) (11 examples) is developed. It proceeds through one-pot three-component coupling of aldehydes, amines and Tms-CN using sulfuric acid adsorbed on silica gel as relatively green catalyst. -(OSKOOIE, H. A.; HERAVI*, M. M.; SADNIA, A.; JANNATI, F.; BEHBAHANI, F. K.; Monatsh.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.