TY - JOUR

T1 - Long-term outcome after transcatheter closure of postinfarction ventricular septal rupture

AU - Heiberg, Johan

AU - Hjortdal, Vibeke Elisabeth

AU - Nielsen-Kudsk, Jens Erik

N1 - © 2014, Wiley Periodicals, Inc.

PY - 2014/10

Y1 - 2014/10

N2 - OBJECTIVES: We report the long-term all-cause mortality and procedure-related complication rate following transcatheter closure of postinfarction ventricular septal rupture (VSR) in a single tertiary center.BACKGROUND: VSR is an exceedingly serious and deathly complication to myocardial infarction. Surgical closure has previously been the treatment of choice, but in the last decade a transcatheter approach has gained ground. However, reports on long-term survival are still sparse and experience is often restricted to large tertiary centers with high flow of patients.METHODS: From January 2000 to April 2013, 9 patients underwent transcatheter closure of a VSR at Aarhus University Hospital. Primary device closure was chosen mainly because of significant risk factors against surgery. Our major endpoints were 30-day, 1-year, and 5-year mortality and years of survival until time of evaluation.RESULTS: Our cohort had a mean age of 75.1 ± 8.4 years, and the median time from VSR to closure was 16 days (2-346). The 30-day, 1-year, and 5-year mortality rates were 11.1%, 33.3%, and 62.5%, respectively. Mean time of postprocedural survival was 4.6 ± 4.4 years at the time of review. Three patients were still alive at the time of review, 1 with a shock-index <1 at the time of VSR closure.CONCLUSIONS: As a single medium-sized tertiary center, we report lower short- and long-term mortality rates compared with most published data on outcome after surgical closure. Our results are comparable to the few previously published reports on transcatheter closure of postinfarction VSRs.

AB - OBJECTIVES: We report the long-term all-cause mortality and procedure-related complication rate following transcatheter closure of postinfarction ventricular septal rupture (VSR) in a single tertiary center.BACKGROUND: VSR is an exceedingly serious and deathly complication to myocardial infarction. Surgical closure has previously been the treatment of choice, but in the last decade a transcatheter approach has gained ground. However, reports on long-term survival are still sparse and experience is often restricted to large tertiary centers with high flow of patients.METHODS: From January 2000 to April 2013, 9 patients underwent transcatheter closure of a VSR at Aarhus University Hospital. Primary device closure was chosen mainly because of significant risk factors against surgery. Our major endpoints were 30-day, 1-year, and 5-year mortality and years of survival until time of evaluation.RESULTS: Our cohort had a mean age of 75.1 ± 8.4 years, and the median time from VSR to closure was 16 days (2-346). The 30-day, 1-year, and 5-year mortality rates were 11.1%, 33.3%, and 62.5%, respectively. Mean time of postprocedural survival was 4.6 ± 4.4 years at the time of review. Three patients were still alive at the time of review, 1 with a shock-index <1 at the time of VSR closure.CONCLUSIONS: As a single medium-sized tertiary center, we report lower short- and long-term mortality rates compared with most published data on outcome after surgical closure. Our results are comparable to the few previously published reports on transcatheter closure of postinfarction VSRs.

KW - Aged

KW - Cardiac Catheterization

KW - Cohort Studies

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Myocardial Infarction/complications

KW - Septal Occluder Device

KW - Ventricular Septal Rupture/etiology

U2 - 10.1111/joic.12146

DO - 10.1111/joic.12146

M3 - Journal article

C2 - 25155883

VL - 27

SP - 509

EP - 515

JO - Journal of Interventional Cardiology

JF - Journal of Interventional Cardiology

SN - 0896-4327

IS - 5

ER -