Zhang Ruoxi, Sun Yong, Sun Meng, Zhang Hui, Hou Jingbo, Yu Bo
Department of Cardiology, Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, 2nd Affiliated Hospital of Harbin Medical University, Harbin 150086, China.
Biomed Res Int. 2017;2017:7971027. doi: 10.1155/2017/7971027. Epub 2017 May 16.
Postinfarction ventricular septal defects (VSD) represent a devastating complication of acute myocardial infarction and are associated with high mortality. Percutaneous interventional closure of postinfarction VSD has been proposed as a potential alternative to surgery. The study aimed to evaluate the therapeutic safety and efficacy of percutaneous interventional closure of postinfarction ventricular septal defects (VSD). Each patient was assigned to one of two groups, based on whether they died during hospitalization (death group) or survived (survival group) in this retrospective study. In-hospital and follow-up data were analyzed. Placement of the VSD occluder was successful in 12 procedures (80%). The mean defect size was 14.20 ± 4.89 mm. Compared to the patients who died, those who survived had higher systolic blood pressure, diastolic blood pressure, and left ventricular ejection fraction upon admission, as well as lower pulmonary/systemic flow ratio and shorter time from acute myocardial infarction to procedure. The incidence of cardiac shock and class IV heart failure was lower in the survival group than in the death group, and these factors correlated with in-hospital and 30-day mortality. Percutaneous closure of postinfarction VSD is an effective technique, which can be performed with a high procedural success rate.
心肌梗死后室间隔缺损（VSD）是急性心肌梗死的一种严重并发症，与高死亡率相关。经皮介入封堵心肌梗死后VSD已被提议作为手术的一种潜在替代方法。本研究旨在评估经皮介入封堵心肌梗死后室间隔缺损（VSD）的治疗安全性和有效性。在这项回顾性研究中，根据患者在住院期间是否死亡（死亡组）或存活（存活组），将每位患者分配到两组中的一组。分析了住院期间和随访数据。12例手术（80%）成功置入VSD封堵器。平均缺损大小为14.20±4.89毫米。与死亡患者相比，存活患者入院时的收缩压、舒张压和左心室射血分数更高，肺循环/体循环血流比更低，从急性心肌梗死到手术的时间更短。存活组的心源性休克和IV级心力衰竭发生率低于死亡组，这些因素与住院期间和30天死亡率相关。经皮封堵心肌梗死后VSD是一种有效的技术，手术成功率高。
