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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 961-965, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
C Blanche, SS Khan, JM Matloff, A Chaux, MA DeRobertis, LS Czer, RM Kass and TP Tsai
A 10-year experience with early operation for postinfarction ventricular
septal defect is reviewed. Twenty-two patients underwent surgical repair;
operative mortality was 36% (< 30 days). The actuarial survival was 64%
at 1 month, 59% at 1 year, and 47% at 5 years. Risk factors predictive of
operative mortality were diabetes (p = 0.001), elevated preoperative right
atrial pressure (p = 0.02), the absence of a preoperative intraaortic
balloon pump (p = 0.006), and a short time interval between infarct and
operation (p = 0.018). Long-term survival was adversely related to diabetes
(p = 0.030), elevated preoperative right atrial pressure (p = 0.005), and,
surprisingly, survival was better in patients with a greater extent of
coronary artery disease (p = 0.023). There were 14 operative survivors
(64%) and 11 long-term survivors (3 months to 10 years, mean 6.0 +/- 3.5
years). Six of eleven survivors were in functional New York Heart
Association class I, one was in class II, and four were in class III.
ARTICLES
Results of early repair of ventricular septal defect after an acute myocardial infarction
Department of Thoracic and Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif. 90048.
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