Surgical treatment of postinfarction ventricular septal defect: risk factors and outcome analysis

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11150%2F18%3A10361699" target="_blank" >RIV/00216208:11150/18:10361699 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00179906:_____/18:10361699

Výsledek na webu

<a href="http://dx.doi.org/10.1093/icvts/ivx230" target="_blank" >http://dx.doi.org/10.1093/icvts/ivx230</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/icvts/ivx230" target="_blank" >10.1093/icvts/ivx230</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Surgical treatment of postinfarction ventricular septal defect: risk factors and outcome analysis

Popis výsledku v původním jazyce

OBJECTIVES: Postinfarction ventricular septal defect is a serious mechanical complication of acute myocardial infarction associated with high postoperative mortality. The aim of this study was to review our experience with surgical repair of postinfarction ventricular septal defect and to identify predictors of early and late outcomes. METHODS: Thirty-nine patients (19 men and 20 women, mean age 68.4 +/- 9.9 years) with postinfarction ventricular septal defect who underwent surgical repair at our institution between 1996 and 2016 were retrospectively evaluated. Risk factors were assessed by univariate analysis, with those found significant included in multivariate analysis. RESULTS: The ventricular septal defect was anterior in 21 (54%) patients and posterior in 18 (46%) patients. Mean aortic cross-clamp time was 91.8 +/- 26.8 min, and mean cardiopulmonary bypass time was 146.3 +/- 49.7 min. Twelve (31%) patients underwent concomitant coronary artery bypass grafting. The 30-day mortality rate was 36% (n = 14). The 30-day survival rate was higher with than without concomitant coronary artery bypass grafting (83% vs 56%), but concomitant coronary artery bypass grafting did not influence late survival (P = 0.098). Univariate analysis identified age, emergency surgery, inotropic support, Killip class, preoperative aspartate aminotransferase concentration, renal replacement therapy and ventricular septal defect diagnosis to operation interval as predictors of 30-day mortality. However, multivariate analysis showed that age and renal replacement therapy were the only independent risk factors of 30-day mortality. CONCLUSIONS: Surgical repair of postinfarction ventricular septal defect has a high 30-day mortality rate. Higher age at presentation and postoperative renal replacement therapy are independent predictors of early mortality.

Název v anglickém jazyce

Surgical treatment of postinfarction ventricular septal defect: risk factors and outcome analysis

Popis výsledku anglicky

OBJECTIVES: Postinfarction ventricular septal defect is a serious mechanical complication of acute myocardial infarction associated with high postoperative mortality. The aim of this study was to review our experience with surgical repair of postinfarction ventricular septal defect and to identify predictors of early and late outcomes. METHODS: Thirty-nine patients (19 men and 20 women, mean age 68.4 +/- 9.9 years) with postinfarction ventricular septal defect who underwent surgical repair at our institution between 1996 and 2016 were retrospectively evaluated. Risk factors were assessed by univariate analysis, with those found significant included in multivariate analysis. RESULTS: The ventricular septal defect was anterior in 21 (54%) patients and posterior in 18 (46%) patients. Mean aortic cross-clamp time was 91.8 +/- 26.8 min, and mean cardiopulmonary bypass time was 146.3 +/- 49.7 min. Twelve (31%) patients underwent concomitant coronary artery bypass grafting. The 30-day mortality rate was 36% (n = 14). The 30-day survival rate was higher with than without concomitant coronary artery bypass grafting (83% vs 56%), but concomitant coronary artery bypass grafting did not influence late survival (P = 0.098). Univariate analysis identified age, emergency surgery, inotropic support, Killip class, preoperative aspartate aminotransferase concentration, renal replacement therapy and ventricular septal defect diagnosis to operation interval as predictors of 30-day mortality. However, multivariate analysis showed that age and renal replacement therapy were the only independent risk factors of 30-day mortality. CONCLUSIONS: Surgical repair of postinfarction ventricular septal defect has a high 30-day mortality rate. Higher age at presentation and postoperative renal replacement therapy are independent predictors of early mortality.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Interactive CardioVascular and Thoracic Surgery

ISSN

1569-9293

e-ISSN

—

Svazek periodika

26

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

6

Strana od-do

41-46

Kód UT WoS článku

000419578900009

EID výsledku v databázi Scopus

2-s2.0-85056803593