Long-term outcome after transcatheter closure of postinfarction ventricular septal rupture

Johan Heiberg, Vibeke Elisabeth Hjortdal, Jens Erik Nielsen-Kudsk

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7 Citations (Scopus)

Abstract

OBJECTIVES: We report the long-term all-cause mortality and procedure-related complication rate following transcatheter closure of postinfarction ventricular septal rupture (VSR) in a single tertiary center.

BACKGROUND: VSR is an exceedingly serious and deathly complication to myocardial infarction. Surgical closure has previously been the treatment of choice, but in the last decade a transcatheter approach has gained ground. However, reports on long-term survival are still sparse and experience is often restricted to large tertiary centers with high flow of patients.

METHODS: From January 2000 to April 2013, 9 patients underwent transcatheter closure of a VSR at Aarhus University Hospital. Primary device closure was chosen mainly because of significant risk factors against surgery. Our major endpoints were 30-day, 1-year, and 5-year mortality and years of survival until time of evaluation.

RESULTS: Our cohort had a mean age of 75.1 ± 8.4 years, and the median time from VSR to closure was 16 days (2-346). The 30-day, 1-year, and 5-year mortality rates were 11.1%, 33.3%, and 62.5%, respectively. Mean time of postprocedural survival was 4.6 ± 4.4 years at the time of review. Three patients were still alive at the time of review, 1 with a shock-index <1 at the time of VSR closure.

CONCLUSIONS: As a single medium-sized tertiary center, we report lower short- and long-term mortality rates compared with most published data on outcome after surgical closure. Our results are comparable to the few previously published reports on transcatheter closure of postinfarction VSRs.

Original languageEnglish
JournalJournal of Interventional Cardiology
Volume27
Issue number5
Pages (from-to)509-15
Number of pages7
ISSN0896-4327
DOIs
Publication statusPublished - Oct 2014

Keywords

  • Aged
  • Cardiac Catheterization
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Myocardial Infarction/complications
  • Septal Occluder Device
  • Ventricular Septal Rupture/etiology

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