Factors influencing survival following postinfarction ventricular septal defects.

Postinfarction ventricular septal defect (VSD) carries a grave prognosis. Surgical closure appears to improve survival. Eighteen patients with postinfarction VSD are reviewed. Nine died before operation could be performed and 9 underwent closure of the VSD; 4 patients are late survivors. Factors which appear to influence survival are: (1) time of surgical intervention after appearance of VSD, (2) presence or absence of cardiogenic shock, (3) location of the infarct, and (4) operative approach to the VSD. Based on these factors, a method of management for postinfarction VSD is outlined.