Document Type : Original Article
Authors
- masood shekarchizadeh 1
- Ata Firuzi 2
- Mona Yadollahi 3
- Arezoo Mohamadifar 4
- Ehsan Ferasati 5
- Mansoureh Shekarchizadeh-Esfahani 6
1 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Cardiovascular Intervention Research center Rajaie Cardiovascular Medical and Research Center Iran Univesity of Medical Sceince , Tehran , Iran
3 Rajaie Cardiovascular Medical and Research Center Iran Univesity of Medical Sceince , Tehran , Iran
4 Department of heart failure and transplantation Rajaie Cardiovascular Medical and Research Center Iran Univesity of Medical Sceince , Tehran , Iran
5 Cardiovascular Department, Kashan Univesity of Medical Sceince , Kashan , Iran
6 Internal Medicine Department,Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Post-infarction ventricular septal rupture (VSR) is a fatal complication of myocardial infarction (MI). The benefits and risks of coronary angiography and subsequent coronary artery bypass grafting are controversial. This study aimed to determine the outcome of revascularization after MI.
Method: Patients aged between 55 to 78 years were candidates from 2011 to 2017. Age, sex, anthropometric measurements, blood pressure, and biochemical parameters such as CPK-MB, Cholesterol, LDL, HDL, and triglycerides are measured by standard methods.
Coronary angiographic factors such as ECG changes, left ventricular (LV), systolic function, right ventricular (RV) function, Pulmonary Artery Pressure (PAP), VSR proximal coronary lesions, systolic PAP, Right Atrial Pressure (RAP), and mortality rate determined.
Results: A total of 81 patients with post-infarction VSR surgically treated were enrolled in the study and divided into two groups; survivors (n=35) and non-survivors (N=41). Age, BMI, eGFR(estimated Glomerular Filtration Rate), total cholesterol, LDL, HDL, and triglycerides are no significant differences. The mean of systolic blood pressure and diastolic blood pressure was higher in the survivor group (115.3 ±18.7 vs. 96.3 ±25.3 and 74.6 ±12.2 vs. 61.2 ±19.0, P=0.001). PCI has been done in 2.9% and 9.8% of survivors vs. non-survivors. The angiographic data indicated that 17 (33%) and 33 (63%) patients had single and multiple coronary artery diseases, respectively. CPK-MB levels were significantly higher in the non-survivors group (P<0.05)..
Conclusion: These results demonstrated that complete revascularization during surgical repair of post-infarction ventricular septal rupture would not improve the outcome, so performing coronary angiography before surgery.
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