Abbasnejad Mohsen, Vand Mehdi Tahmasebi, Khamnian Zhila, Separham Ahmad
Department of Cardiology, Tabriz University of Medical Science, Tabriz, Iran.
Kardiochir Torakochirurgia Pol. 2018 Dec;15(4):227-232. doi: 10.5114/kitp.2018.80918. Epub 2018 Dec 31.
Ventricular septal defect (VSD) is a rare but life-threatening complication of acute myocardial infarction (AMI). There is a paucity of data regarding the natural history of this devastating complication of myocardial infarction in the Middle East region with restricted financial resources and unsolved major health problems.
To evaluate the clinical presentation and in-hospital outcome of patients with post-infarction VSD over a 10-year period in a tertiary center in northwest Iran.
Data from 64 consecutive patients with VSD complicating AMI were retrospectively analyzed from March 2005 to May 2015.
The mean age of the patients was 71.62 ±9.38 years with 57.8% of them being female. The VSDs were anterior in 52 (82%) patients. More than half of patients were in cardiogenic shock during the initial presentation. Multivessel coronary artery disease was found on coronary angiography in 70.3% of patients. In-hospital mortality was 82.8%. Multivariate analysis revealed cardiogenic shock (HR = 12.5, = 0.001) as the only independent predictor of in-hospital mortality and surgical treatment as the only predictor of in-hospital survival (HR = 0.2, = 0.02).
Our study demonstrated that VSD complicating myocardial infarction had an extremely high in-hospital mortality rate. Cardiogenic shock was the only independent predictor of in-hospital mortality and surgical treatment was the only predictor of in-hospital survival.
室间隔缺损（VSD）是急性心肌梗死（AMI）一种罕见但危及生命的并发症。在中东地区，由于财政资源有限且重大健康问题尚未解决，关于心肌梗死这种严重并发症自然史的数据匮乏。
评估伊朗西北部一家三级中心10年间心肌梗死后室间隔缺损患者的临床表现及院内结局。
回顾性分析2005年3月至2015年5月期间64例连续发生急性心肌梗死合并室间隔缺损患者的数据。
患者的平均年龄为71.62±9.38岁，其中57.8%为女性。52例（82%）患者的室间隔缺损位于前部。超过半数患者在初次就诊时处于心源性休克状态。70.3%的患者冠状动脉造影显示多支冠状动脉病变。院内死亡率为82.8%。多因素分析显示，心源性休克（HR = 12.5，P = 0.001）是院内死亡的唯一独立预测因素，手术治疗是院内生存的唯一预测因素（HR = 0.2，P = 0.02）。
我们的研究表明，心肌梗死合并室间隔缺损的院内死亡率极高。心源性休克是院内死亡的唯一独立预测因素，手术治疗是院内生存的唯一预测因素。
