ArticleJTCVS open2026
Postmyocardial infarction ventricular septal defect outcomes: Partial versus full presurgical hemodynamic support.
Article in JTCVS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Objectives: Ventricular septal defects (VSDs) are life-threatening complications of myocardial infarctions (MIs), and the role of presurgical hemodynamic support remains unclear. This study compared outcomes of patients with post-MI VSDs in cardiogenic shock (CS) receiving different levels of presurgical hemodynamic support. Methods: Patients from January 1, 2011, to December 31, 2024, in CS with post-MI VSDs undergoing surgical patch repair at this single center were included. Patients with intra-aortic balloon pumps (IABP), Impella CP, or only pharmacologic presurgical hemodynamic support were placed in the partial support (PS) group; patients on venoarterial-extracorporeal membrane oxygenation (VA-ECMO) and/or Impella 5.0/5.5 before surgery were placed in the full support (FS) group. Discharge and 1-year clinical outcomes plus complications were compared between groups. Results: This study included 29 patients, with 15 patients (51.7%) in the PS group and 14 patients (48.3%) in the FS group. In the PS group, 12 patients (80%) had IABPs, 2 patients (13.3%) had only pharmacologic support, and 1 patient (6.7%) had Impella CP support. In the FS group, 5 patients (35.7%) had Impella 5.0/5.5 alone, 6 patients (42.9%) had IABP plus Impella 5.0/5.5, and 3 patients (21.4%) had IABP, Impella 5.0/5.5, and VA-ECMO. Mortality was greater in the PS group compared with the FS group at discharge (46.7% vs 14.3%, Conclusions: Among patients with post-MI VSDs in CS, 1-year mortality was significantly lower among patients on full presurgical hemodynamic support as compared with partial presurgical hemodynamic support.
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