Longitudinal Outcomes After Surgical Repair of PostInfarction Ventricular Septal Defect in the Medicare population.

This study uses short-term clinical data from the Society of Thoracic Surgeons (STS) National Database linked with Medicare data to examine longer-term outcomes in these patients. METHODS: This was a retrospective review of the STS National Database to link with Medicare data all adults (≥65 years) who underwent VSD repair following a myocardial infarction between 2008-2012. The primary outcome was 1-year mortality. Risk factors for 1-year survival were modeled using a multivariable Cox regression. RESULTS: A total of 537 patients were identified using the STS database and medicare linkage. Median age was 74 years, and 277(52%) were men. 192(36%) were supported preoperatively with an intra-aortic balloon pump. Surgical status was emergent or salvage in 138(26%). 158(29%) died within 30-days and 207 (39%) patients died within 1-year. Among patients who survived to hospital discharge, 44% were discharged to a facility, and 172(32%) experienced at least one all-cause re-admission within 1-year. Unadjusted 1-year mortality rates were 13% for elective patients and 69% for emergency status (p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research

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We describe two cases of ventr icular septal defect complicating acute myocardial infarction, where the percutaneous ImpellaCP was implanted early (differently than previously described) with the aim of preventing haemodynamic instability, while deferring surgical repair. We present a report of haemodynamic, echocardiographic, bi ochemical, and clinical data of two consecutive cases of ImpellaCP use, within a minimally invasive monitoring and therapeutic approach. In two cases of subacute myocardial infarction‐related ventricular septal defect not amenable to percutaneous device closure, the use ImpellaCP was successful:...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research
ConclusionsOur method is a rational approach that effectively reduces residual leakage.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: SURGICAL TECHNIQUE Source Type: research
PMID: 31782751 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
A 40-something suffered witnessed ventricular fibrillation, had bystander CPR, but could not be defibrillated after 4 attempts.He was transferred to the ED and put on extracorporeal life support (ECLS, ECMO).A series of ED Transesophageal echos (TEE) was done over 23 minutes before an ECG was recorded.  We usually do not get ROSC before angiography in these cases, and recording the ECG is not as important as usual, because we send them all to the cath lab by our ECMO protocol.This is before another defibrillation attempt, during chest compressions:Orientation:The probe is in the esophagus, right next to the left ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Interventricular septal hematoma (IVSH) is rarely reported in association with congenital cardiac surgical repair and is more commonly related to cardiac trauma or myocardial infarction in the adult cardiac patient. When linked to congenital cardiac surgery, the few cases reported are usually in conjunction with a perimembranous ventricular septal defect (VSD) repair. Although the mechanism for IVSH is not clear, the leading theory involves injury to the septal perforating artery during suture placement in the VSD repair.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
This study uses short-term clinical data from the Society of Thoracic Surgeons (STS) National Database linked with Medicare data to examine longer-term outcomes in these patients.MethodsThis was a retrospective review of the STS National Database to link with Medicare data all adults (≥65 years) who underwent VSD repair following a myocardial infarction between 2008-2012. The primary outcome was 1-year mortality. Risk factors for 1-year survival were modeled using a multivariable Cox regression.ResultsA total of 537 patients were identified using the STS database and medicare linkage. Median age was 74 years, and 277(52...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSIONS: Post-MI VSD remains a devastating complication in Japan as well as in the USA and Europe. PMID: 31511450 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
A 64 year-old man (155 cm, 56 kg) presented to hospital with an ST-elevation myocardial infarction after experiencing 6 hours of chest pain. He was taken to the cardiac catheterization laboratory where he suffered a ventricular tachycardia cardiac arrest requiring 2 minutes of cardiopulmonary resuscitation, endotracheal intubation, mechanical ventilation, and placement of an intraaortic balloon pump. Coronary angiography demonstrated severe multivessel coronary artery disease with acutely occluded left anterior descending and right coronary arteries and a large post-infarction ventricular septal defect (VSD).
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Diagnostic Dilemma Source Type: research
AbstractPurpose of ReviewThis review aims to delineate the actual role of percutaneous intervention in the closure of post-myocardial infarction ventricular septal defect (post-MI VSD) and to briefly summarize the main steps of this procedure.Recent FindingsMost of the published studies report experiences using Amplatzer devices for post-MI VSD closure. In the acute phase, morbidity and mortality are quite high up to 70%, with a mean success rate of 90%, with 95% confidence intervals from 60 to 100%, and a 30-day mortality of 40%, with 95% confidence intervals from 0 to 55%. In the chronic phase, that is 14  days afte...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
Conclusion: CABG after ECLS was very rare in real-world circumstances. Although the early mortality rate was high, the risk of mortality may be acceptable under such devastating circumstances. PMID: 31089443 [PubMed]
Source: Korean Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research
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