The current clinical practice for management of post-infarction ventricular septal rupture: a European survey
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The current clinical practice for management of post-infarction ventricular septal rupture: a European survey. / Ronco, Daniele; Ariza-Solé, Albert; Kowalewski, Mariusz; Matteucci, Matteo; Di Mauro, Michele; López-de-Sá, Esteban; Ranucci, Marco; Sionis, Alessandro; Bonaros, Nikolaos; De Bonis, Michele; Russo, Claudio Francesco; Uribarri, Aitor; Montero, Santiago; Fischlein, Theodor; Kowalówka, Adam; Naito, Shiho; Obadia, Jean-François; Martín-Asenjo, Roberto; Aboal, Jaime; Thielmann, Matthias; Simon, Caterina; Andrea-Riba, Rut; Parra, Carolina; Folliguet, Thierry; Martínez-Sellés, Manuel; Sanmartín Fernández, Marcelo; Al-Attar, Nawwar; Viana Tejedor, Ana; Serraino, Giuseppe Filiberto; Burgos Palacios, Virginia; Boeken, Udo; Raposeiras Roubin, Sergio; Solla Buceta, Miguel Antonio; Sánchez Fernández, Pedro Luis; Scrofani, Roberto; Pastor Báez, Gemma; Jorge Pérez, Pablo; Actis Dato, Guglielmo; Garcia-Rubira, Juan Carlos; de Gea Garcia, Jose H; Massimi, Giulio; Musazzi, Andrea; Lorusso, Roberto.
in: European heart journal open, Jahrgang 3, Nr. 5, 09.2023, S. oead091.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The current clinical practice for management of post-infarction ventricular septal rupture: a European survey
AU - Ronco, Daniele
AU - Ariza-Solé, Albert
AU - Kowalewski, Mariusz
AU - Matteucci, Matteo
AU - Di Mauro, Michele
AU - López-de-Sá, Esteban
AU - Ranucci, Marco
AU - Sionis, Alessandro
AU - Bonaros, Nikolaos
AU - De Bonis, Michele
AU - Russo, Claudio Francesco
AU - Uribarri, Aitor
AU - Montero, Santiago
AU - Fischlein, Theodor
AU - Kowalówka, Adam
AU - Naito, Shiho
AU - Obadia, Jean-François
AU - Martín-Asenjo, Roberto
AU - Aboal, Jaime
AU - Thielmann, Matthias
AU - Simon, Caterina
AU - Andrea-Riba, Rut
AU - Parra, Carolina
AU - Folliguet, Thierry
AU - Martínez-Sellés, Manuel
AU - Sanmartín Fernández, Marcelo
AU - Al-Attar, Nawwar
AU - Viana Tejedor, Ana
AU - Serraino, Giuseppe Filiberto
AU - Burgos Palacios, Virginia
AU - Boeken, Udo
AU - Raposeiras Roubin, Sergio
AU - Solla Buceta, Miguel Antonio
AU - Sánchez Fernández, Pedro Luis
AU - Scrofani, Roberto
AU - Pastor Báez, Gemma
AU - Jorge Pérez, Pablo
AU - Actis Dato, Guglielmo
AU - Garcia-Rubira, Juan Carlos
AU - de Gea Garcia, Jose H
AU - Massimi, Giulio
AU - Musazzi, Andrea
AU - Lorusso, Roberto
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023/9
Y1 - 2023/9
N2 - AIMS: 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.METHODS AND RESULTS: 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.CONCLUSION: 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.
AB - AIMS: 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.METHODS AND RESULTS: 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.CONCLUSION: 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.
U2 - 10.1093/ehjopen/oead091
DO - 10.1093/ehjopen/oead091
M3 - SCORING: Journal article
C2 - 37840585
VL - 3
SP - oead091
JO - European heart journal open
JF - European heart journal open
SN - 2752-4191
IS - 5
ER -