TY - JOUR
T1 - The current clinical practice for management of post-infarction ventricular septal rupture :
T2 - a European survey
AU - Ronco, Daniele
AU - Ariza-Solé, Albert
AU - Kowalewski, Mariusz
AU - Matteucci, Matteo
AU - Di Mauro, Michele
AU - Lopez-de-Sa, Esteban
AU - Ranucci, Marco
AU - Sionis, Alessandro
AU - Bonaros, Nikolaos
AU - De Bonis, Michele
AU - Russo, Claudio Francesco
AU - Uribarri, Aitor
AU - Montero, Santiago
AU - Fischlein, Theodor J. M.
AU - Kowalówka, Adam R.
AU - Naito, Shiho
AU - Obadia, Jean François
AU - Martín-Asenjo, Roberto
AU - Aboal, Jaime
AU - Thielmann, Matthias
AU - Simon, Caterina
AU - Andrea-Riba, Rut
AU - Parra, Carolina
AU - Folliguet, Thierry
AU - Martínez-Sellés, Manuel
AU - Fernández, Marcelo Sanmartín
AU - Al-Attar, Nawwar H. K.
AU - Tejedor, Ana Viana
AU - Serraino, Giuseppe Filiberto
AU - Burgos Palacios, Virginia
AU - Boeken, Udo
AU - Raposeiras-Roubin, Sergio
AU - Solla Buceta, Miguel Antonio
AU - Sánchez Fernández, Pedro Luis
AU - Scrofani, Roberto
AU - Pastor Báez, Gemma
AU - Pérez, Pablo Jorge
AU - Dato, Guglielmo Actis
AU - Garcia-Rubira, Juan C.
AU - De Gea Garcia, José Higinio
AU - Massimi, Giulio
AU - Musazzi, Andrea
AU - Lorusso, Roberto R.
PY - 2023
Y1 - 2023
N2 - Many historical and recent reports showed that post-infarction ventricular septal rupture (VSR) represents a life-threatening condition and the strategy to optimally manage it remains undefined. Therefore, disparate treatment policies among different centres with variable results are often described. We analysed data from European centres to capture the current clinical practice in VSR management. Thirty-nine centres belonging to eight European countries participated in a survey, filling a digital form of 38 questions from April to October 2022, to collect information about all the aspects of VSR treatment. Most centres encounter 1-5 VSR cases/year. Surgery remains the treatment of choice over percutaneous closure (71.8% vs. 28.2%). A delayed repair represents the preferred approach (87.2%). Haemodynamic conditions influence the management in almost all centres, although some try to achieve patients stabilization and delayed surgery even in cardiogenic shock. Although 33.3% of centres do not perform coronarography in unstable patients, revascularization approaches are widely variable. Most centres adopt mechanical circulatory support (MCS), mostly extracorporeal membrane oxygenation, especially pre-operatively to stabilize patients and achieve delayed repair. Post-operatively, such MCS are more often adopted in patients with ventricular dysfunction. In real-life, delayed surgery, regardless of the haemodynamic conditions, is the preferred strategy for VSR management in Europe. Extracorporeal membrane oxygenation is becoming the most frequently adopted MCS as bridge-to-operation. This survey provides a useful background to develop dedicated, prospective studies to strengthen the current evidence on VSR treatment and to help improving its currently unsatisfactory outcomes. Graphical Abstract First-line approach for management of post-acute myocardial infarction ventricular septal rupture according to interviewed centres.
AB - Many historical and recent reports showed that post-infarction ventricular septal rupture (VSR) represents a life-threatening condition and the strategy to optimally manage it remains undefined. Therefore, disparate treatment policies among different centres with variable results are often described. We analysed data from European centres to capture the current clinical practice in VSR management. Thirty-nine centres belonging to eight European countries participated in a survey, filling a digital form of 38 questions from April to October 2022, to collect information about all the aspects of VSR treatment. Most centres encounter 1-5 VSR cases/year. Surgery remains the treatment of choice over percutaneous closure (71.8% vs. 28.2%). A delayed repair represents the preferred approach (87.2%). Haemodynamic conditions influence the management in almost all centres, although some try to achieve patients stabilization and delayed surgery even in cardiogenic shock. Although 33.3% of centres do not perform coronarography in unstable patients, revascularization approaches are widely variable. Most centres adopt mechanical circulatory support (MCS), mostly extracorporeal membrane oxygenation, especially pre-operatively to stabilize patients and achieve delayed repair. Post-operatively, such MCS are more often adopted in patients with ventricular dysfunction. In real-life, delayed surgery, regardless of the haemodynamic conditions, is the preferred strategy for VSR management in Europe. Extracorporeal membrane oxygenation is becoming the most frequently adopted MCS as bridge-to-operation. This survey provides a useful background to develop dedicated, prospective studies to strengthen the current evidence on VSR treatment and to help improving its currently unsatisfactory outcomes. Graphical Abstract First-line approach for management of post-acute myocardial infarction ventricular septal rupture according to interviewed centres.
KW - Acute myocardial infarction
KW - Cardiogenic shock
KW - Extracorporeal membrane oxygenation
KW - Mechanical circulatory support
KW - Mechanical complication
KW - Ventricular septal rupture
UR - https://www.scopus.com/pages/publications/85174947440
U2 - 10.1093/ehjopen/oead091
DO - 10.1093/ehjopen/oead091
M3 - Article
C2 - 37840585
SN - 2752-4191
VL - 3
JO - European Heart Journal Open
JF - European Heart Journal Open
IS - 5
ER -