Which patients might be suitable for a septal occluder device closure of postinfarction ventricular septal rupture rather than immediate surgery?

Interactive Cardiovascular and Thoracic Surgery
Rizwan Attia, Christopher Blauth

Abstract

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: which patients might be suitable for a transcatheter closure (TCC) of their postinfarction ventricular septal rupture (VSR) rather than immediate surgery? Thirty papers were found using the reported search, five of which represented the best evidence to answer the clinical question. The main limitations were the paucity of level 1 evidence on this topic. Only one study provided a prospective series as part of a registry; the remaining were retrospective cohort analyses. Although multivariate analysis may adequately control for measurable biases, unmeasured bias may still exist and influence the results. All studies agreed that timing of intervention is critical in determining the outcome. Patient's preoperative haemodynamic status was a major determinant of postoperative survival. Successful outcome after TCC was in patients with simple defects, <15 mm in diameter that were in the sub-acute (>3.5 weeks) or chronic stage following acute myocardial infarct (AMI). Procedural success rate varied from 73.6% to 91%. Three of five studies looking at TCC closure concluded that procedural success does not necessarily tran...Continue Reading

References

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Citations

Jun 28, 2014·European Heart Journal·Brandon M JonesAmar Krishnaswamy
Nov 6, 2013·Cardiology Clinics·Ramesh S KuttyNarain Moorjani
Nov 29, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Feroze Mahmood, Madhav Swaminathan
Mar 15, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Erica SteinJohn G T Augoustides
Apr 12, 2013·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Susumu IsodaTadaaki Maehara
Jan 28, 2017·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Yuji NishidaGo Watanabe
Apr 1, 2012·European Heart Journal. Acute Cardiovascular Care·Cláudia JorgeAntónio Nunes Diogo
Oct 20, 2017·Interactive Cardiovascular and Thoracic Surgery·Marek PojarJan Vojacek
Sep 1, 2016·Surgical Case Reports·Katsukiyo KitabayashiNobuo Sakagoshi
Aug 17, 2021·Current Opinion in Cardiology·Ali Fatehi HassanabadImtiaz S Ali
Sep 10, 2021·Journal of Cardiac Surgery·Fahad Alfares, Satinder K Sandhu
Nov 19, 2021·General Thoracic and Cardiovascular Surgery·Jiawei Zhou, Chao Liu

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