Does optimal delay improve outcomes in the surgical management of post MIVSR?

Excerpt

Post-myocardial infarct ventricular septal rupture (PMIVSR) is a serious mechanical complication which carries a very high mortality if not treated surgically. Since the first closure described by Cooley in 1957, techniques have evolved and results have improved. It is a challenge, not only technically but also in the management, right from admission preoperatively to discharge. Mechanical circulatory support has helped improve outcomes in this sick cohort. In spite of this, 30-day mortality rates in different studies continue to be in the range of 20 to 60% [1‐5]. There are not many large series to deeply analyze predictors of outcome, which are multivariate. Cardiogenic shock, posterior infarcts, operating early, and presence of renal dysfunction have been all known to be associated with poorer outcomes. …