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Chest, Vol 95, 292-298, Copyright © 1989 by American College of Chest Physicians

ARTICLES

Acute ventricular septal rupture. Angiographic-morphologic features and clinical assessment

O Topaz, SM Mallon, RA Chahine, RF Sequeira and RJ Myerburg
Department of Medicine, University of Miami School of Medicine 33101.

Twenty patients with acute ventricular septal rupture underwent cardiac catheterization. Prior to catheterization, 17 patients were in Killip class 3-4. Mean cardiac index and cardiac output were 2.03 +/- 0.81 L/min/m2 and 3.55 +/- 1.33 L/min, respectively. Based on a recent pathologic description of septal rupture, we encountered by angiography and during surgery, two morphologic types of rupture: simple type which appears as a direct through-and-through communication between the ventricles, and complex type which presents hemorrhagic tracts in the septum with the opening into the ventricles at different levels. Considering the management of patients with septal rupture and the clinical outcome in our series, it is suggested that there is a need to minimize invasive angiographic procedures prior to early surgical correction of the ruptured septum.


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B. S. Crenshaw, C. B. Granger, Y. Birnbaum, K. S. Pieper, D. C. Morris, N. S. Kleiman, A. Vahanian, R. M. Califf, and E. J. Topol
Risk Factors, Angiographic Patterns, and Outcomes in Patients With Ventricular Septal Defect Complicating Acute Myocardial Infarction
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[Abstract] [Full Text] [PDF]


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Copyright © 1989 by the American College of Chest Physicians.