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Relationship between Complete Revascularization and Survival after Post-InfarctionVentricular Septal Rupture
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نویسنده
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firuzi ata ,shekarchizadeh masood ,yadollahi mona ,mohamadifar arezoo ,ferasati ehsan ,shekarchizadeh-esfahani mansoureh
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منبع
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arya atherosclerosis - 2023 - دوره : 19 - شماره : 3 - صفحه:18 -24
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چکیده
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Introduction: a well-known and fatal complication of myocardial infarction (mi) is post-infarctionventricular septal rupture (vsr). the benefits and risks associated with coronary angiography andsubsequent coronary artery bypass grafting in these patients have sparked controversy. the aim of this studywas to determine the outcome of revascularization following mi.method: patients aged between 55 and 78 years were considered for the post-infarction ventricularseptal rupture from 2011 to 2017. factors such as age, sex, anthropometric measurements, systolic anddiastolic blood pressure (sbp and dbp), and biochemical parameters like cpk-mb, cholesterol, low-densitylipoprotein, high-density lipoprotein, and triglycerides were measured using standard methods.the estimated glomerular filtration rate (egfr), a measure of kidney function, was also determined.additionally, coronary angiographic factors including ecg changes, left ventricular (lv) systolic function,right ventricular (rv) function, pulmonary artery pressure (pap), proximal coronary lesions in vsr, systolicpap, right atrial pressure (rap), and mortality rate were determined.results: the study enrolled a total of 81 patients who had been surgically treated for post-infarction vsr.these patients were divided into two groups: survivors (n=35) and non-survivors (n=41). the mean systolicand diastolic blood pressure was higher in the survivor group (115.3 ± 18.7 vs. 96.3 ± 25.3 and 74.6 ± 12.2 vs.61.2 ± 19.0, p=0.001). pci was performed in 2.9% of survivors and 9.8% of non-survivors. angiographic datarevealed that 17 (33%) and 33 (63%) patients had single and multiple coronary artery diseases, respectively.cpk-mb levels were significantly higher in the non-survivors group (p<0.05). echocardiographic findings,including lv ejection fraction, rv ejection fraction, systolic pap, and the anatomic location of vsr, did notsignificantly differ between survivors and non-survivors.conclusion: based on these findings, it is recommended to avoid complete revascularization duringsurgical repair of post-infarction ventricular septal rupture, as it would not improve the outcome.
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کلیدواژه
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Revascularization ,Post-infarction ventricular septal rupture ,Coronary angiography ,CABG ,MI ,VSR
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آدرس
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iran univesity of medical sceince, cardiovascular intervention research center rajaie cardiovascular medical and research center, Iran, isfahan university of medical sciences, isfahan cardiovascular research center, cardiovascular research institute, iran, iran university of medical sciences, rajaie cardiovascular medical and research center, Iran, iran university of medical sciences, rajaie cardiovascular medical and research center, department of heart failure and transplantation, Iran, kashan univesity of medical sceince, cardiovascular department, Iran, isfahan university of medical sciences, internal medicine department, Iran
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Authors
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