Comparison of clinical efficacy and prognosis between interventional occlusion and surgical treatment for acute myocardial infarction with ventricular septal perforation.

Comparación de la eficacia clínica y el pronóstico entre la oclusión intervencionista y el tratamiento quirúrgico en el infarto agudo de miocardio con perforación del septo ventricular.

• Chenyao Ni Zhejiang University, Hangzhou, China. https://orcid.org/0009-0000-9662-4093
• Peng Hu Zhejiang University, Hangzhou, China https://orcid.org/0009-0000-4780-0492
• Yiming Ni Zhejiang University, Hangzhou, China. https://orcid.org/0000-0002-2909-6734

DOI: https://doi.org/10.54817/IC.v65n1a07

Keywords: acute myocardial infarction, interventricular septal perforation, interventional occlusion, Killip class, EuroScore II, NYHA class, 6-minute walk test

Abstract

This retrospective study compared the clinical outcomes and prognostic factors in acute myocardial infarction-related patients with interventricular septal perforation (AMI-VSP) who underwent interventional occlusion (IO group) or surgical intervention (SI group). Forty-six patients were analyzed based on comprehensive clinical data, laboratory results, and follow-up evaluations. The SI group had higher EuroScore II scores and more patients in Killip class IV. Both treatments showed improved laboratory indices, but the IO group had higher left ventricular ejection fraction and lower levels of specific biomarkers. The postoperative hospital stay and total hospitalization time were shorter in the IO group. Survival rates did not significantly differ between the two groups during the follow-up period. Logistic regression analysis identified a history of coronary heart disease as a significant risk factor affecting prognosis and survival rates. Both interventional occlusion and surgical intervention proved effective, with IO showing faster recovery and more favorable prognoses, while surgery was preferred for severe cases. Coronary heart disease was a key factor influencing postoperative survival in AMI-VSP patients.

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