Comparison of clinical efficacy and prognosis between interventional occlusion and surgical treatment for acute myocardial infarction with ventricular septal perforation.

Chenyao Ni, Peng Hu, Yiming Ni
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Abstract

This retrospective study compared the clinical outcomes and prognostic factors in acute myocardial infarction-related patients with inter-ventricular septal perforation (AMI-VSP) who underwent interventional occlu-sion (IO group) or surgical intervention (SI group). Forty-six patients were ana-lyzed based on comprehensive clinical data, laboratory results, and follow-up evaluations. The SI group had higher EuroScore II scores and more patients in Killip class IV. Both treatments showed improved laboratory indices, but the IO group had higher left ventricular ejection fraction and lower levels of specific biomarkers. The postoperative hospital stay and total hospitalization time were shorter in the IO group. Survival rates did not significantly differ between the two groups during the follow-up period. Logistic regression analysis identified a history of coronary heart disease as a significant risk factor affecting progno-sis and survival rates. Both interventional occlusion and surgical intervention proved effective, with IO showing faster recovery and more favorable prognoses, while surgery was preferred for severe cases. Coronary heart disease was a key factor influencing postoperative survival in AMI-VSP patients.
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急性心肌梗死伴室间隔穿孔的介入性闭塞与手术治疗的临床疗效和预后比较。
这项回顾性研究比较了急性心肌梗死相关的室间隔穿孔(AMI-VSP)患者接受介入性闭塞(IO 组)或外科干预(SI 组)后的临床疗效和预后因素。根据全面的临床数据、实验室结果和随访评估,对 46 名患者进行了分析。SI组的EuroScore II评分更高,Killip IV级患者更多。两种治疗方法都改善了实验室指标,但 IO 组的左心室射血分数更高,特定生物标志物水平更低。IO 组的术后住院时间和总住院时间更短。两组患者在随访期间的存活率无明显差异。逻辑回归分析发现,冠心病史是影响预后和存活率的重要风险因素。事实证明,介入性闭塞治疗和手术治疗均有效,其中介入性闭塞治疗恢复更快,预后更佳,而手术治疗则更适用于严重病例。冠心病是影响 AMI-VSP 患者术后存活率的关键因素。
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