ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
EARLY SURGICAL TREATMENT IN POSTINFARCT VENTRICULAR SEPTAL DEFECT
Gökçen Orhan, Okan Yücel, *Yeşim Biçer, Murat Sargın, Şahin Şenay, Bülent Ketenci, Erol Kurç, Serap Aykut Aka
Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul
*Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Kliniği, İstanbul
Background: The anatomical localization of ventricular septal defect (VSD) occured after acute myocardial infarction (MI) strictly affects the type of surgery. New prosthetic patches and rapid progression in surgical techniques, increased experiences in anesthesiology and reanimation augment our surgical success. In our study we searched for the factors affecting the rate of hospital mortality.

Methods: Between April 1990 and October 2002, 21 consecutive patients underwent surgical repair of post-MI VSD. Group 1 consists 12 patients who were alive postoperatively, and Group 2 consists 9 patients who died. All patients were evaluated by echocardiography, and cardiac angiography and catheterization were performed on 18 patients. We studied preoperative, peroperative and postoperative clinical findings retrospectively.

Results: The hospital mortality was 42.85%. The risk factors for early mortality were older age, the anatomical localization of post-MI VSD, the presence of cardiogenic shock preoperatively, low ejection fraction, late surgical treatment (72 hrs later), prolonged cross clamp time and total bypass period, and late application of intraaortic ballon pump.

Conclusions: Whereever the anatomical localization of post-MI VSD is, early surgical treatment is necessary. That decreases the rate of postoperative mortality if it is performed before the occurance of multiorgan failure.

Keywords : Acute myocardial infarction, ventricular septal defect, multiorgan dysfunction
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