Cadogan Diarmaid, Daghem Marwa, Snosi Mostafa, Williams Lynne K, Weir-McCall Jonathan, Calvert Patrick A, Giblett Joel P
Department of Cardiology, Liverpool Heart and Chest Hospital Liverpool, UK.
Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital UK.
Interv Cardiol. 2023 May 26;18:e19. doi: 10.15420/icr.2023.01. eCollection 2023.
Post-infarction ventricular septal defect is a mechanical complication of acute MI. The incidence of this complication is low in the primary percutaneous coronary intervention era. However, the associated mortality is very high at 94% with medical management alone. Open surgical repair or percutaneous transcatheter closure still has an in-hospital mortality >40%. Retrospective comparisons between both closure methods are limited by observation and selection bias. This review addresses the assessment and optimisation of patients prior to repair, the optimal timing of repair, and the limitations in current data. The review considers techniques for percutaneous closure, and finally considers the path that future research should take to improve outcomes for patients.
心肌梗死后室间隔缺损是急性心肌梗死的一种机械性并发症。在直接经皮冠状动脉介入治疗时代，这种并发症的发生率较低。然而，仅采用药物治疗时，其相关死亡率非常高，达94%。开放手术修复或经皮导管封堵的住院死亡率仍>40%。两种封堵方法之间的回顾性比较受到观察和选择偏倚的限制。本综述探讨了修复前患者的评估和优化、最佳修复时机以及当前数据的局限性。该综述考虑了经皮封堵技术，最后探讨了未来研究应采取的途径，以改善患者的治疗效果。
