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Circulation, Vol 64, 545-553, Copyright © 1981 by American Heart Association
MJ Radford, RA Johnson, WM Daggett Jr, JT Fallon, MJ Buckley, HK Gold and RC Leinbach
Forty-one patients with postinfarction ventricular septal rupture were
cared for in our hospital during 1971-1975. Cardiogenic shock developed
after septal rupture in 55% of these patients. Shock was unrelated to site
of infarction, extent of coronary artery disease, left ventricular ejection
fraction, or pulmonary-to-systemic flow ratio, but mean pulmonary artery
pressure was lower in shock than in nonshock patients. These observations
suggest that shock was produced mainly by right ventricular impairment.
Perioperative survival was much higher in patients who did not have shock
preoperatively (14 of 17 [82+]) than in those who did (three of 11 [27%]).
Magnitude of shunt, left ventricular ejection fraction, extent of coronary
artery disease, and performance of aortocoronary bypass grafting were not
distinctly correlated with perioperative survival. After a minimum 4-year
follow-up, 76% of the perioperative survivors are alive, and none suffer
more than New York Heart Association functional class II disability. All 13
unoperated patients (11 in shock) died within 3 months.
ARTICLES
Ventricular septal rupture: a review of clinical and physiologic features and an analysis of survival
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