• Nicholson Yam, Timmy Wing-Kuk Au, and Lik-Cheung Cheng.
• Division of Cardiothoracic Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
• Asian Cardiovasc Thorac Ann. 2013 Oct 1;21(5):539-45.

BackgroundPost-infarction ventricular septal defects require surgical closure. Only a few studies have been conducted in Asian populations. This study reports the current outcomes and determinants affecting survival.MethodsBetween January 1995 and January 2012, 40 patients underwent surgery for post-infarction ventricular septal defect. We analyzed demographics, clinical, angiographic, and echocardiographic parameters, operative data, postoperative morbidity, and survival. Mean follow-up was 5.2 ± 5.3 years. Univariate and multivariate analyses were used to determine the factors affecting 30-day mortality and long-term survival.ResultsThere was no intraoperative death. Our 30-day mortality was 20%. Single-vessel disease was found on coronary angiography in 63% of patients. Eight patients had concomitant coronary artery bypass grafting. Overall survival at 1, 5, and 10 years was 68%, 55%, and 42%, respectively. Event-free survival from subsequent angina, myocardial infarction, congestive heart failure, or percutaneous interventions at 1, 5, and 10 years was 66%, 43%, and 25%, respectively. Preoperative oliguria and postoperative sepsis were independent predictors of 30-days mortality on multivariate analysis (p = 0.02). Preoperative left ventricular function was associated with long-term survival (p = 0.048).ConclusionWe had good results of current postinfarction ventricular septal defect repair. Selected patients had concomitant coronary artery bypass grafting. Preoperative oliguria and postoperative sepsis were independent predictors of 30-day mortality, while left ventricular function was related to long-term survival.

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