Effect of thrombolytic therapy on the patterns of post myocardial infarction ventricular septal rupture

Srinivas, Sunil Kumar; Sunil, B; Bhat, Prabhavathi; Manjunath, Cholenahally Nanjappa

doi:10.1016/j.ihj.2017.03.007

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…40 Furthermore, the median time to VSR formation post-MI was significantly shorter in patients receiving thrombolysis treatment than in those without thrombolysis treatment, and compared with late thrombolysis treatment, early thrombolysis treatment was associated with shorter median time to post-MI VSR formation. 41 Results of subgroup analyses showed that in the subgroup of patients with VSR, female gender, older age, and LAD involvement remained risk factors for CR. In the subgroup of patients with STEMI, the risk factors were female gender and older age.…”

Section: Original Research Discussionmentioning

confidence: 94%

“…The timing of thrombolytic therapy for AMI has been shown to be associated with CR risk, with more prolonged time to treatment after MI associated with increasing risk (7 hours, OR=0.4; 11 hours, OR=0.93; 17 hours, OR=3.21) 40. Furthermore, the median time to VSR formation post-MI was significantly shorter in patients receiving thrombolysis treatment than in those without thrombolysis treatment, and compared with late thrombolysis treatment, early thrombolysis treatment was associated with shorter median time to post-MI VSR formation 41…”

Section: Discussionmentioning

confidence: 95%

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Risk Factors for Cardiac Rupture Complicating Myocardial Infarction: A PRISMA Meta-Analysis and Systematic Review

Hao

Guo

et al. 2019

Journal of Investigative Medicine

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Cardiac rupture (CR) is a complication of acute myocardial infarction (AMI) that is associated with a high mortality rate. This study aimed to identify the risk factors for CR in patients with AMI. Medline, Cochrane, EMBASE, and Google Scholar databases were searched for relevant literature published through September 16, 2018. Eligible studies included patients with AMI and compared factors between patients with and without CR. Sixteen studies were identified and included in the meta-analysis. Results revealed that female gender (pooled OR=2.72, 95% CI 2.04 to 3.63, p<0.001), older age (pooled difference in means=6.91, 95% CI 4.20 to 9.62, p<0.001), infarction at left anterior descending coronary artery (LAD) (pooled OR=1.85, 95% CI 1.03 to 3.32, p=0.039), and anterior wall infarction (pooled OR=1.87, 95% CI 1.30 to 2.68, p=0.001) were associated with increased risk of CR, whereas history of MI, smoking, and multivessel disease were associated with reduced risk of CR. Patients treated with primary percutaneous coronary intervention (PCI) had reduced risk of CR, while patients who had received any thrombolysis had increased risk of CR. In conclusion, results of systematic review and meta-analysis of existing literature suggest that risk factors for CR in patients with AMI include female gender, older age, new-onset MI, non-smoking status, LAD infarction, anterior wall infarction, and single-vessel disease. Furthermore, treatment with primary PCI may help reduce the risk for CR, while thrombolysis might increase the risk for CR.

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Section: Original Research Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 95%

Risk Factors for Cardiac Rupture Complicating Myocardial Infarction: A PRISMA Meta-Analysis and Systematic Review

Hao

Guo

et al. 2019

Journal of Investigative Medicine

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“…These interventions are important to stabilize the patient's condition in preparation for further repair. If pharmacological therapy is not effective, Intra-aortic balloon pump (IABP) should be used [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction

Shafiei¹,

Jannati²,

Jannati³

2020

Journal of the Saudi Heart Association

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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.

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“…Intra-aortic balloon pump (IABP) should be considered if pharmacological therapy fails to achieve hemodynamic stability. 12,15 IABP can support these patients by lowering afterload and also decreasing the shunt and at the same time facilitating coronary perfusion.…”

Section: Discussionmentioning

confidence: 99%

Delayed Surgical Repair of Ventricular Septal Rupture with CABG following Acute Myocardial Infraction- A Case Report

et al. 2022

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Ventricular septal rupture (VSR) is a rare but often life-threatening mechanical complication after acute myocardial infarction. Although surgical intervention is challenging and associated with high mortality and morbidity, but it is still now the gold standard treatment. Percutaneous device closure of VSR is an option in selected patients with suitable anatomy and when surgery is contraindicated. Optimally medically managed patients who survive at least 4 weeks before elective surgery to generate scar formation at the edges of the defect in a viable infarcted tissue have the greatest outcomes. Here we report a case of VSR following acute myocardial infarction. About 3 weeks after the occurrence of ventricular septal rupture following acute myocardial infraction, surgery was successfully performed with good outcome. Cardiovasc j 2022; 15(1): 100-105

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Effect of thrombolytic therapy on the patterns of post myocardial infarction ventricular septal rupture

Cited by 9 publications

References 30 publications

Risk Factors for Cardiac Rupture Complicating Myocardial Infarction: A PRISMA Meta-Analysis and Systematic Review

Risk Factors for Cardiac Rupture Complicating Myocardial Infarction: A PRISMA Meta-Analysis and Systematic Review

Optimal Time Repair of Ventricular Septal Rupture Post Myocardial Infarction

Delayed Surgical Repair of Ventricular Septal Rupture with CABG following Acute Myocardial Infraction- A Case Report

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