Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(7), 737–744. https://doi.org/10.1002/clc.24027 Tongfeng Chen et al.
Points
- This research investigates the safety and effectiveness of percutaneous closure procedures for ventricular septal rupture (VSR) following acute myocardial infarction (AMI).
- The study analyzed data from 81 patients who underwent transcatheter VSR closure, comparing clinical outcomes between survival and death groups and identifying risk factors for 30-day mortality.
- Patients in the death group exhibited higher levels of biomarkers such as CRP, white blood cells, and NT-ProBNP, with a higher use of vasoactive drugs and a shorter time from AMI to operation.
- The mortality rate was significantly lower when VSR closure was performed three weeks post-AMI compared to within the first three weeks.
- Successful device implantation improved cardiac function, reduced Qp/Qs, pulmonary artery systolic pressure, and increased aortic systolic pressure, with increased CRP and NT-ProBNP serving as risk factors for 30-day post-closure mortality.
Summary
This research paper assessed the effectiveness and safety of percutaneous closure procedures for ventricular septal rupture (VSR) after acute myocardial infarction (AMI). The study encompassed 81 patients who underwent transcatheter VSR closure, and a comprehensive analysis was conducted, considering clinical data during hospitalization and a 30-day follow-up period. Comparative evaluations were made between patients who survived and those who did not, shedding light on the optimal timing for closure and the overall safety and efficacy of the procedure. Logistic regression analysis was employed to identify the risk factors associated with mortality within 30 days post-operation.
The study’s results revealed notable differences between the survival and death groups. Key biomarkers such as C-reactive protein (CRP), white blood cell counts, N-terminal pro-brain natriuretic peptide (NT-ProBNP), and aspartate aminotransferase exhibited significantly higher levels in the death group compared to the survival group. Moreover, patients in the death group had higher utilization of vasoactive drugs and underwent VSR closure sooner after AMI. Remarkably, the mortality rate was substantially lower when the closure procedure was performed three weeks post-AMI as opposed to within the first three weeks (12.5% vs. 48%). The study also reported successful device implantation in most patients, albeit with some operation-related complications and valve injuries. Additionally, cardiac function notably improved, marked by changes in various parameters such as Qp/Qs, pulmonary artery systolic pressure, aortic systolic pressure, ejection fraction (EF), and left ventricular end-diastolic dimension (LVDd) after VSR closure. CRP and NT-ProBNP increase were significant risk factors for 30-day post-closure mortality.
In conclusion, the findings suggest that percutaneous VSR closure is a promising therapeutic option for eligible patients experiencing VSR following AMI. The study highlights the importance of optimal timing for the procedure and underscores the potential improvements in cardiac function and outcomes for individuals undergoing this intervention.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24027
References Chen, T., Liu, Y., Zhang, J., Sun, Z., Han, Y., & Gao, C. (2023). Percutaneous closure of ventricular septal rupture after myocardial infarction: A retrospective study of 81 cases. Clinical Cardiology, 46(7), 737–744. https://doi.org/10.1002/clc.24027
