Post-infarction ventricular septal defect: the importance of site of infarction and cardiogenic shock on outcome

1 January 1989

journal article
Published by Oxford University Press (OUP) in European Journal of Cardio-Thoracic Surgery

Vol. 3 (6) , 554-557
https://doi.org/10.1016/1010-7940(89)90118-8

Abstract

Sixty-eight patients operated upon for post-infarction VSD from 1980-1987 have been reviewed to identify incremental risk factors whichinfluence survival. Univariate and multivariate analysis was performed on19 parameters and showed the following in decreasing order of importance tobe significantly associated with non-survival: (1) operation within 24 h ofoccurrence of the VSD; (2) inferior infarct preceding the VSD; (3)requirement for inotropic support preoperatively; (4) preoperativecardiogenic shock; (5) a lower mean pulmonary artery pressure; (6) a lowermean wedge pressure; (7) a lower mean systolic pressure. The presence of agraft to the right coronary artery was associated with a better prognosis.Age, sex, diastolic blood pressure, balloon pumping, mean plasma urea,right atrial pressure, extent of coronary disease, number of coronarygrafts, grafts to the left coronary system and method of myocardialpreservation had no influence on survival.

Keywords

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