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 report our early postoperative outcomes of repair versus replacement.MethodsData were collected for patients undergoing first ‐time mitral valve surgery for severe IMR between 1990 and 2009 (n = 393). Patients who underwent combined procedures for papillary muscle rupture, post‐infarction ventricular septal defect, endocarditis, or any previous cardiac surgery were excluded. Preoperative demographics, operative variables, and hospital outcomes were analyzed, and multivariable regre ssion analysis was employed to identify independent predictors of hospital mortality.ResultsValve repair was performed in ...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conclusion The strategy of delayed surgery may be a reasonable solution in selected patients with VSD complicating AMI. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: The Thoracic and Cardiovascular Surgeon Reports - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Case Report: Cardiac Source Type: research
VENTRICULAR SEPTAL RUPTURE, resulting in a ventricular septal defect (VSD), is a catastrophic complication after an acute myocardial infarction (MI). Although the incidence of post –myocardial infarction ventricular septal defect (PMI VSD) has decreased dramatically in the thrombolytic and percutaneous coronary intervention era, the perioperative mortality remains elevated.1 Historically, in medically treated patients the mortality rates exceeded 90%, and thus, early surgica l repair first was proposed in the 1980s.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
AbstractDuring the COVID ‐19 pandemic, emergency room visits have drastically decreased for non‐COVID conditions such as appendicitis, heart attack, and stroke. Patients may be avoiding seeking medical attention for fear of catching the deadly condition or as an unintended consequence of stay‐at‐home orders. This de lay in seeking care can lead to increased morbidity and mortality, which has not been figured in the assessment of the extent of damage caused by this pandemic. This case illustrates an example of “collateral damage” caused by the COVID‐19 pandemic. What would have been a standard ST‐ele...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
AbstractBackground and Aim of the StudyVentricular septal defect (VSD) following myocardial infarction (MI) is a relatively infrequent complication with high mortality. We sought to investigate the effect of concomitant coronary artery bypass graft (CABG) on outcomes following post ‐MI VSD repair.MethodsElectronic search was performed to identify all relevant studies published from 2000 to 2018. Sixty ‐seven studies were selected for the analysis comprising 2174 patients with post‐MI VSD. Demographic information, perioperative variables, and outcomes including survival data were extracted and pooled for systematic re...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: REVIEW ARTICLE Source Type: research
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
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