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Review Article
Current Concepts
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Volume 347:1426-1432 October 31, 2002 Number 18
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Ventricular Septal Rupture after Acute Myocardial Infarction
Yochai Birnbaum, M.D., Michael C. Fishbein, M.D., Carlos Blanche, M.D., and Robert J. Siegel, M.D.

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When ventricular septal rupture complicates acute myocardial infarction, the mortality is high. Reperfusion therapy has reduced the incidence of septal rupture. However, rapid diagnosis, aggressive medical management, and surgical intervention are required to optimize recovery and survival. This review summarizes information on septal rupture in both the era before thrombolytic therapy and after the advent of reperfusion therapy.

Incidence

In the era before reperfusion therapy, septal rupture complicated 1 to 3 percent of acute myocardial infarctions.1,2,3,4,5 Among the 41,021 patients in the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial, ventricular septal rupture was suspected . . . [Full Text of this Article]

Risk Factors

Pathogenesis

Hemodynamics

Angiographic Findings

Time Course

Clinical Manifestations

Diagnosis

Medical Therapy

Mechanical Closure

Postoperative Care

Prognosis


Source Information

From the Division of Cardiology, University of Texas Medical Branch, Galveston (Y.B.); the Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles (M.C.F.); and the Divisions of Cardiothoracic Surgery (C.B.) and Cardiology (R.J.S.), Cedars–Sinai Medical Center, Los Angeles.

Address reprint requests to Dr. Birnbaum at the Division of Cardiology, University of Texas Medical Branch at Galveston, 5,106 John Sealy Annex, 301 University Blvd., Galveston, TX 77555-0553, or at yobirnba@utmb.edu.


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