In-hospital outcome of patients with post-MI VSD: a single-center study.

Introduction: Ventricular septal defect (VSD) is a rare but life-threatening complication of acute myocardial infarction (AMI). There is a paucity of data regarding the natural history of this devastating complication of myocardial infarction in the Middle East region with restricted financial resources and unsolved major health problems.

Aim: To evaluate the clinical presentation and in-hospital outcome of patients with post-infarction VSD over a 10-year period in a tertiary center in northwest Iran.

Material and methods: Data from 64 consecutive patients with VSD complicating AMI were retrospectively analyzed from March 2005 to May 2015.

Results: The mean age of the patients was 71.62 ±9.38 years with 57.8% of them being female. The VSDs were anterior in 52 (82%) patients. More than half of patients were in cardiogenic shock during the initial presentation. Multivessel coronary artery disease was found on coronary angiography in 70.3% of patients. In-hospital mortality was 82.8%. Multivariate analysis revealed cardiogenic shock (HR = 12.5, p = 0.001) as the only independent predictor of in-hospital mortality and surgical treatment as the only predictor of in-hospital survival (HR = 0.2, p = 0.02).

Conclusions: Our study demonstrated that VSD complicating myocardial infarction had an extremely high in-hospital mortality rate. Cardiogenic shock was the only independent predictor of in-hospital mortality and surgical treatment was the only predictor of in-hospital survival.