Early and midterm outcomes of triple patch technique for postinfarction ventricular septal defects

Abstract

Early and midterm outcomes of modified infarct exclusion using the triple patch technique are acceptable. This technique is safe and simple, and may be useful for reducing postoperative residual shunt.

Mechanical circulatory support for early surgical repair of postinfarction ventricular septal defect with cardiogenic shock

“…However, in an analysis of the Society of Thoracic Surgeons national database by Arnaoutakis et al that was published a little more than a decade after the initial GUSTO trial, 51.7% of the patients were in cardiogenic shock at admission or prior to intervention, with a 30‐day mortality rate of 42.9% 6 . In recent studies with smaller sample sizes, however, perioperative mortality ranges from a minimum of 4.3% 13 to a maximum of 65.0%, 10 with the majority of studies ranging between 20% and 40% 7‐9,14,15 . In patients with pVSD, pre‐operative CS appears to be the most important variable among risk factors for in‐hospital mortality, and many authors have been able to substantiate this link over the years, whereby overall mortality usually increases with the increase in the number of patients in CS 4,6,9,10,16 .…”

“…6 In recent studies with smaller sample sizes, however, perioperative mortality ranges from a minimum of 4.3% 13 to a maximum of 65.0%, 10 with the majority of studies ranging between 20% and 40%. [7][8][9]14,15 In patients with pVSD, pre-operative CS appears to be the most important variable among risk factors for in-hospital mortality, and many authors have been able to substantiate this link over the years, whereby overall mortality usually increases with the increase in the number of patients in CS. 4,6,9,10,16 However, it seems reasonable that a forced emergency or ultima ratio surgery is associated with a poor outcome due to hemodynamic deterioration.…”

Septal rupture closure: Still a challenge

“…But times are changing. Several studies using contemporary data report that the 30‐day mortality after surgical repair ranges from 0.0 to 35.0% . When compared with rates reported by Goldsweig et al, these lower percentages may be explained by improvements in surgical techniques, post‐operative care, or patient selection bias.…”

Preoperative Venoarterial Extracorporeal Membrane Oxygenation Slashes Risk Score in Advanced Structural Heart Disease

“…Advanced structural heart disease leading to cardiogenic shock or end-organ dysfunction carries significant operative risk. Operative mortality for ischemic VSD repair is reported between 24% and 56%, with cardiogenic shock or early intervention imposing even further risk [3,17,19,20]. Severe mitral regurgitation secondary to a ruptured papillary muscle carries a 40% mortality risk, with low cardiac output being a risk factor [4].…”