Percutaneous Closure of Post-Infarction Ventricular Septal Defects-An Over Decade-long Experience.
J Interv Cardiol
; 30(1): 63-71, 2017 Feb.
Article
em En
| MEDLINE
| ID: mdl-28078714
ABSTRACT
OBJECTIVES:
To report an over decade-long experience with percutaneous post-infarction ventricular septal defect (PIVSD) closure.BACKGROUND:
PIVSDs remains a major clinical challenge with extremely high mortality. Data concerning interventional closure of PIVSD is scarce.METHODS:
All percutaneous PIVSD closures performed between 2003 and 2016 in 8 participating centres were identified. Data concerning patients and procedures was acquired. Patients were divided into two groups, based on the time interval between VSD diagnosis and closure (≤14 days-acute phase, >14 days-non-acute phase).RESULTS:
Twenty-one percutaneous PIVSD closures were performed on 20 patients (9 females, mean age 70 years). Mean interval between the diagnosis and the procedure was 182.6 ± 500 days (range 7-2228). Defects were mostly located in apical (55%) segments of the septum. In 7 cases (33%) the procedure was performed in the acute phase. The closure was technically successful in 17 cases (81%). Four patients died within 48 hours after the procedure. 30-days survival rate of the entire cohort was 70%. Univariate analysis revealed impact of technical success of the procedure (HR 0.13, CI 0.03-0.68 P = 0.016) and white blood cell count (HR 1.36 per unit increase, CI 1.1-1.69, P = 0.005) on 30-day mortality.CONCLUSIONS:
In a selected population of patients percutaneous PIVSD closure is feasible and provides satisfactory survival rate. Procedural success has a protective impact on survival. Timing of the closure remains controversial. Procedure in the non-acute phase carries lower mortality, but at the same time introduces a selection bias. Larger registry-based studies are required.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Intervenção Coronária Percutânea
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Comunicação Interventricular
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Infarto do Miocárdio
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Interv Cardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Polônia