Surgical repair of post infarct ventricular septal rupture in Peshawar Institute of cardiology: Experience in a newly established tertiary care hospital.

Abstract

Objective: To share our experience of post infarct closure of ventricular septal rupture in newly established cardiac center. Study Design: Retrospective study. Setting: Department of Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar. Period: Jan 2021 to August 2024. Methods: All VSR repair cases done during this period were included which were 10. Results: A total of 10 cases of surgical repair of VSR were included in the study. 50 % were males. Mean age was 65 years (IQR 14.7). 40 % were diabetic while 80% were hypertensive. 20% patients had thrombolysis while 60% had PPCI. 50 % patients presented with NYHA IV symptoms. 10% patients were in pre operative AKI. 40% were in cardiogenic shock. 10 % had pre operative IABP passed while 50 % were stabilized with preoperative ionotropic support. 90% of VSR were anterior while 10% posterior. Median VSR size was 13.5 mm (IQR 12.2mm). 20 % VSR were multiple. Median time from onset of symptoms to VSR was 4 days (IQR 2.5). Median time from hospital presentation to VSR repair was 15 days (IQR 20.7). Concomitant CABG was performed in 90% cases. Post operative median ICU stay was 4 days (IQR 4.7) while hospital stay was 7 days (IQR 7.2). Residual VSR, pleural effusion, reopening, post Operative AKI, stroke and heart failure each were present in 10% cases. In hospital mortality was 10%. Conclusion: Optimal timing of surgery and preoperative status of patients are important determinant to decrease postoperative complications and mortality.