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To investigate the clinical characteristics, treatment strategies and prognosis in patients with ventricular septal rupture(VSR)following acute myocardial infarction (AMI).
Clinical data of 73 patients with VSR complicated with AMI in The General Hospital of Shenyang Military Region from August 2008 to June 2016 were analyzed retrospectively.
For 73 patients with VSR,43 cases were female ;the average age was 67.2±9.4 years. There were 42 hypertensive patients and 61 patients followed by acute anterior myocardial infarction. Left ventricular ejection fraction (LVEF) was 52%±11%, Left ventricular size was 52.1±7.4mm. There were 41 patients received conservative treatment, and their 1-month survival rate was 17.1%, 3-months survival rate was 7.3%. 18 patients had transcatheter VSR closure treatment, their 1-month and 3-months survival rate was 80%. 14 patients had surgical treatment, their 1-month and 3-months survival rate was 100%. The patients with transcatheter VSR closure and surgical treatment presented much better survival rate than those with conservative treatment, P <0.005.
VSD is an infrequent but devastating complication of AMI. The conservative treatment mortality is high, If transcatheter VSR closure or Surgical repair had be performed after 3-4 weeks of conservative treatment, the outcome was better. Once the operation is successful, long-term prognosis can be improved.