The Enlargement Rate of Ventricular Septal Rupture: An Overlooked Risk
Factor of Delayed Surgery
Objective: The aim of the study was to analyze the impact of rupture
size on surgical outcomes of ventricular septal rupture. Methods: During
a 15-year period, from Jan 2006 to Dec 2020, 112 patients underwent
repairs of postinfarction ventricular septal rupture. Data were
collected on clinical, angiographic, and echocardiographic findings;
operative procedures; early morbidity and mortality; and survival time.
Univariable and multivariable analyses were performed to identify risk
factors of 30-day mortality. Results: Thirty-day mortality was 7.1% for
the whole cohort. The mean survival time estimate was 147.2 (95% Cl
135.6-158.9) months, with a 3-year survival rate of 91.2% and a 5-year
survival rate of 89.0%. Multivariable analysis regarded rupture
enlargement gradient as an independent risk factor of 30-day mortality.
The ROC curve indicated that rupture enlargement gradient predicted
30-day mortality with high accuracy. Conclusions: Delayed surgery could
be considered for patients who respond well to aggressive treatment.
Rupture enlargement gradient is an independent risk factor for
postoperative 30-days morality of delayed VSR repair and has good
predictive power for the prognosis of VSR patients.