The current clinical practice for management of post-infarction ventricular septal rupture : a European survey
Ronco, Daniele (Innovative Medical Forum)
Ariza-Solé, Albert (Hospital Universitari de Bellvitge)
Kowalewski, Mariusz (Central Clinical Hospital of the Ministry of Interior)
Matteucci, Matteo (University of Insubria)
Di Mauro, Michele (Maastricht University Medical Centre (Maastricht, Països Baixos))
Lopez-de-Sa, Esteban (Hospital Universitario La Paz (Madrid))
Ranucci, Marco (IRCCS Policlinico San Donato (Itàlia))
Sionis, Alessandro (Institut d'Investigació Biomèdica Sant Pau)
Bonaros, Nikolaos (Medical University of Innsbruck)
De Bonis, Michele (San Raffaele University Hospital)
Russo, Claudio Francesco (ASST Grande Ospedale Metropolitano Niguarda)
Uribarri, Aitor (Hospital Clínico Universitario de Valladolid)
Montero, Santiago (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Fischlein, Theodor J. M. (Paracelsus Medical University)
Kowalówka, Adam R. (School of Medicine in Katowice)
Naito, Shiho (University Heart & Vascular Center Hamburg)
Obadia, Jean François (Louis Pradel Cardiologic Hospital)
Martín-Asenjo, Roberto (Instituto Investigación Sanitaria Hospital 12 de Octubre)
Aboal, Jaime (Hospital Universitari de Girona Doctor Josep Trueta)
Thielmann, Matthias (University Duisburg-Essen)
Simon, Caterina (Papa Giovanni XXIII Hospital (Bèrgam, Itàlia))
Andrea-Riba, Rut (Hospital Clínic i Provincial de Barcelona)
Parra, Carolina (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Folliguet, Thierry (Assistance Publique-Hopitaux de Paris Créteil)
Martínez-Sellés, Manuel (Hospital General Universitario Gregorio Marañón)
Fernández, Marcelo Sanmartín (Hospital Universitario Ramón y Cajal (Madrid))
Al-Attar, Nawwar H. K. (Golden Jubilee National Hospital)
Tejedor, Ana Viana (Hospital Universitario Clínico San Carlos (Madrid))
Serraino, Giuseppe Filiberto (University of Catanzaro)
Burgos Palacios, Virginia (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Boeken, Udo (University Hospital of Düsseldorf (Alemanya))
Raposeiras-Roubin, Sergio (Hospital Álvaro Cunqueiro (Vigo))
Solla Buceta, Miguel Antonio (Hospital Universitario de A Coruña)
Sánchez Fernández, Pedro Luis (Complejo Asistencial Universitario Salamanca)
Scrofani, Roberto (Ospedale Maggiore Policlinico)
Pastor Báez, Gemma (Hospital Clínico Universitario de Valladolid)
Pérez, Pablo Jorge (Hospital Universitari de les Canàries)
Dato, Guglielmo Actis (Mauriziano Hospital (Itàlia))
Garcia-Rubira, Juan C. (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
De Gea Garcia, José Higinio (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Massimi, Giulio (Collegium Medicum Nicolaus Copernicus University)
Musazzi, Andrea (University of Insubria)
Lorusso, Roberto R. (Cardiovascular Research Institute Maastricht)
Universitat Autònoma de Barcelona

Fecha:	2023
Resumen:	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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Acute myocardial infarction ; Cardiogenic shock ; Extracorporeal membrane oxygenation ; Mechanical circulatory support ; Mechanical complication ; Ventricular septal rupture
Publicado en:	European Heart Journal Open, Vol. 3 Núm. 5 (january 2023) , p. oead091, ISSN 2752-4191

DOI: 10.1093/ehjopen/oead091
PMID: 37840585

7 p, 633.9 KB

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