Post-infarction ventricular septal rupture: short-term outcomes. Seven-year Russian single-center experience

Full abstract

Read the full abstract

Aim . To evaluate short-term clinical and procedural outcomes in patients with post-infarction ventricular septal rupture (PIVSR). Material and methods . This single-center, retrospective, non-randomized, observational cohort study included patients with PIVSR admitted to the Chazov National Medical Research Center of Cardiology in Moscow between 2019 and 2025. The analysis was conducted according to the type of procedure performed. The primary endpoint was any-cause inhospital mortality, with secondary endpoints including inhospital cardiovascular mortality and the rate of technical and procedural success after curative treatment. Results . In the period 2019-2025, the study included 94 patients with PIVSR (mean age, 68,5±12 years women, 56,4%). Open surgical repair was performed in 35,1% (33/94) of patients, while percutaneous closure (PC) — in 50,0% (47/94), conservative treatment — in 12,8% (12/94), and heart transplantation or implantation of a long-term left ventricular assist device with immediate open surgical repair. Secondary open surgical repair after PC was performed in 14,9% (7/47) of patients. Cardiogenic shock occurred in 62,8% (59/94) of patients: in the open surgical repair group — in 36,4% (12/33), in the PC group — in 83% (39/47). Mechanical circulatory support was used in 53,2% (50/94) of cases. Any-cause inhospital mortality was 53,3% (49/92): 74,5% (35/47) with PC, and 21,2% (7/33) with open surgical repair, and 58,3% (7/12) with conservative treatment. In the general group, 34,8% (32/92) of patients died from cardiovascular causes. In the open surgical repair and PC groups, technical success was achieved in 97,5% and 87,2%, and procedural success — in 72,7% and 51,1%, respectively. Conclusion . Approximately half of patients with PIVSR survive to discharge with a comprehensive treatment approach. In our center’s experience, various curative treatment methods complement each other and are used in patient populations with different clinical severity. The results highlight the need for further research aimed at optimizing the strategy, specifically the choice of intervention type and timing, and the use of mechanical circulatory support.