Indian heart journal最新文献

{"title":"The effect of mavacamten on echocardiographic parameters, cardiac function and biomarkers in hypertrophic cardiomyopathy patients, a systematic review and meta-analysis.","authors":"Zina Otmani, Noura Abdrabou, Hazem Ayman Elsayed, Mazen Negmeldin Aly Yassin, Mohamed Abouzid, Mahmoud Diaa Hindawi, Ayman K Awad","doi":"10.1016/j.ihj.2025.05.011","DOIUrl":"10.1016/j.ihj.2025.05.011","url":null,"abstract":"<p><strong>Background: </strong>Evaluate the effect of mavacamten on echocardiographic parameters and cardiac biomarkers in patients with hypertrophic cardiomyopathy (HCM).</p><p><strong>Methods: </strong>We searched PubMed, SCOPUS, Web of Science, and Cochrane Library until November 2023. Results were reported as mean difference (MD) and Risk Ratio (RR) with 95 % confidence intervals (CI).</p><p><strong>Results: </strong>Seven studies with 524 patients (456 with obstructive HCM and 59 with non-obstructive HCM) were included. Mavacamten significantly improved septal early diastolic mitral annular velocity (e') (MD 0.78, 95 % CI [0.51 to 1.05]) and left ventricular mass index (LVMI). It reduced left ventricular outflow tract (LVOT) gradient, NT-proBNP (MD -557.14, 95 % CI [-685.59 to -428.68]), and troponin levels. Improvements were also seen in left atrial volume index (MD -6.26, 95 % CI [-8.88 to -3.63]) and E/e' ratios, particularly in obstructive HCM patients.</p><p><strong>Conclusion: </strong>Mavacamten enhances echocardiographic and cardiac biomarker outcomes in HCM patients on short-term follow-up. Limited data on non-obstructive HCM require cautious interpretation.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of pacemaker pocket infection - an observational study.","authors":"Manish Kapoor, Arun Kumar Gunasekaran, Valerie Lyngdoh, Reuben Lamiaki Kynta, Pinak Pani Das","doi":"10.1016/j.ihj.2025.05.009","DOIUrl":"10.1016/j.ihj.2025.05.009","url":null,"abstract":"<p><p>This retrospective, hospital-based observational study was aimed to examine the indications for PPM implantation, risk factors, demographics, and microbiological profiles of PPM infections (PPMI). The study included patients presenting with local inflammatory signs and excluded those under 18 years old. Of the 716 patients who underwent Cardiac Implantable Electronic Device (CIED) implantation, 37.7 % received single-chamber devices and 52.8 % received double-chamber devices. PPMI was identified in 15 patients (2.09 %), with infections more prevalent in devices implanted over 12 months prior. Diabetes (36.11 %) and hypertension (32.56 %) were the most common comorbidities. Culture-negative infections (53.33 %) predominated, followed by methicillin-resistant Staphylococcus aureus (MRSA) (33.33 %).</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early outcomes of aortic valve neocuspidization (the Ozaki procedure): Initial experience of a single centre.","authors":"Ranajit Naik, Abhishek Prabhu, Mohan Gan, Richard Saldanha","doi":"10.1016/j.ihj.2025.05.008","DOIUrl":"10.1016/j.ihj.2025.05.008","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic valve neocuspidization (AVNeo) using fixed autologous pericardium, also known as the Ozaki technique, is an effective therapy for treating aortic valvulopathies. It serves as an alternative to complex aortic valve repair, offering better hemodynamics compared to biological or mechanical valve replacement, without the need for lifelong anticoagulation.</p><p><strong>Objectives: </strong>To evaluate the immediate and early outcomes of our initial experience with the AVNeo procedure in a spectrum of aortic valve diseases.</p><p><strong>Methods: </strong>In this retrospective cohort study, seventeen AVNeo procedures were performed between March 2023 and October 2023 at our center. All patients completed one year of follow-up. Outcomes were assessed by echocardiographic evaluation postoperatively and at one year, including complications and mortality.</p><p><strong>Results: </strong>Patient age ranged from 7 to 77 years (mean 35.2 ± 22.4 years), with 3 females among the 17 patients. Aortic valve morphology was bicuspid in 6 (35.3 %) and tricuspid in 11 (64.7 %) patients. Twelve patients had aortic stenosis as the primary pathology, and five had moderate to severe aortic regurgitation. In aortic stenosis patients, the preoperative mean peak gradient was 82.3 ± 20.3 mmHg, and mean gradient was 48.9 ± 18.5 mmHg. Postoperatively, mean peak gradient reduced to 9 ± 5.3 mmHg, and mean gradient to 16.7 ± 9.1 mmHg. Two patients required conversion to prosthetic valve replacement for progressive aortic regurgitation. There was no mortality at one year, though one patient developed severe aortic regurgitation.</p><p><strong>Conclusion: </strong>AVNeo is a feasible, reproducible procedure with favorable early outcomes, low pressure gradients, and mild regurgitation at one year. It is a cost-effective option, particularly in resource-limited settings like India.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of cardiology fellow training based on COCATS-4 framework: A cross-sectional study from three tertiary care institutes across India.","authors":"Atit A Gawalkar, Ganesh Paramasivam, Krishna Prasad Akkineni, Mahek Vijayvergiya, Pragya Karki, Nirmal Ghati, R Padmakumar, Rajiv Narang, Rajesh Vijayvergiya","doi":"10.1016/j.ihj.2025.05.010","DOIUrl":"10.1016/j.ihj.2025.05.010","url":null,"abstract":"<p><strong>Background: </strong>The Core Cardiology Training Symposium (COCATS) guidelines, endorsed by the American College of Cardiology (ACC) emphasize competency-based training and establish milestones to be met during cardiology training. However, India lacks such guidelines for training cardiology fellows.</p><p><strong>Objectives: </strong>The study aimed to evaluate the self-declared competencies of cardiology fellows across multiple preselected domains as per the COCATS-4 recommendations.</p><p><strong>Methods: </strong>The study was conducted at three premier institutions across India between June 2022 and December 2024. A total of 52 cardiology fellows who had recently completed their 3-year core cardiology training course were included in the study. These candidates completed a questionnaire that included a checklist assessing different levels of competency in various preselected aspects of cardiovascular medicine. Candidates were also asked about their awareness of COCATS-4 standards and cardiology training in India.</p><p><strong>Results: </strong>While all trainees reported Level 1 competency in cardiac catheterization, heart failure, and adult congenital heart disease, a significantly lower percentage of trainees achieved Level 1 competency in nuclear medicine (1.9 %), cardiac MRI (3.8 %), and cardiac CT (17.3 %). At Level 2, cardiac catheterization (73.1 %) and echocardiography (63.5 %) had the highest self-declared competencies, whereas nuclear medicine (3.8 %), cardiac MRI (0 %), and cardiac CT (0 %) had the lowest. Only 23.1 % of trainees were aware of COCATS-4, and 82.7 % believed that standardized guidelines would improve cardiology training in India.</p><p><strong>Conclusions: </strong>The results emphasize the wide variability in self-reported competencies of cardiology trainees across India and highlight the deficiencies in certain core areas like cardiovascular imaging.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of Induction Time in Adult Patients with Valvular Heart Disease.","authors":"Tanya Mital, Suruchi Hasija, Sambhunath Das, Sandeep Chauhan, Maroof A Khan","doi":"10.1016/j.ihj.2025.05.007","DOIUrl":"10.1016/j.ihj.2025.05.007","url":null,"abstract":"<p><strong>Objective: </strong>Intravenous anaesthetics induce loss of consciousness in one arm-brain circulation time. As the circulatory transit time in patients with mitral stenosis (MS) and aortic stenosis (AS) is increased, the delivery of anaesthetics to the brain may be prolonged and consequently the onset of hypnosis. This study aimed to compare the induction time in patients with and without valvular heart disease (VHD).</p><p><strong>Design: </strong>Prospective, single-center, open-label analytical study.</p><p><strong>Setting: </strong>It was conducted in adult patients undergoing elective cardiac surgery.</p><p><strong>Participants: </strong>The patients (n = 144) were segregated into three groups; Group 1 - Stenotic VHD (MS, AS), Group 2 - Regurgitant VHD (Mitral Regurgitation, Aortic Regurgitation), and Group 3 - Control (coronary artery disease).</p><p><strong>Method: </strong>General anaesthesia was induced with intravenous thiopental 4mg kg^-1 bolus over 20s. The time to induction was noted as loss of eyelash reflex. Bispectral Index (BIS) values were recorded over 2 min. Statistical analysis was performed using SPSS software version 25.0. A p value < 0.05 was considered significant.</p><p><strong>Main results: </strong>Patients in Group 1 (n = 48) had significantly prolonged induction time (99.6 ± 12.9s; p < 0.001) compared to the other two groups (n = 48 each) (68.5 ± 9.6s in Group 2 and 70.4 ± 11.8s in Group 3). Time required for BIS to fall below 60 was significantly longer in Group 1 (139.4 ± 24.6s; p < 0.001) compared to Group 2 (90.4 ± 6.3s) and Group 3 (92.1 ± 12s).</p><p><strong>Conclusion: </strong>The induction time was prolonged in patients with stenotic VHD compared to patients with regurgitant VHD or those without VHD.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term outcomes of drug-coated balloons versus drug-eluting stents in patients with small vessel coronary artery disease.","authors":"Hesham Refaat, Mohamed Arab","doi":"10.1016/j.ihj.2025.05.004","DOIUrl":"10.1016/j.ihj.2025.05.004","url":null,"abstract":"<p><strong>Objective: </strong>Drug-eluting stents (DES) are a normative care of coronary stenosis. However, their efficacy was limited by stent thrombosis and in-stent restenosis especially in small vessel coronary artery disease (SvCAD). The aim of this study was to assess angiographic efficacy and clinical outcomes of drug coated balloons (DCB) as compared with DES in SvCAD setting.</p><p><strong>Methods: </strong>A total of 100 SvCAD patients with percutaeous angioplasty of culprit coronary arteries <3 mm diameter and >70 % stenosis were enrolled in this study. The patients were categorized into DES arm and DCB arm. One year clinical outcomes were assessed. The primary endpoint was in-lesion late lumen loss (LLL). The secondary endpoints were vessel thrombosis, major bleeding, all-cause death and major adverse cardiac events (MACEs).</p><p><strong>Results: </strong>One year clinical follow-up revealed that in-lesion LLL was significantly lower in DCB arm as compared with DES arm (p = 0.004). Composite MACE was significantly higher in DES group compared to DCB group (p < 0.001). Non-fatal myocardial infarction (MI), target lesion revascularization (TLR), and major bleeding in DES group were significantly higher than DCB group (p = 0.04 & p < 0.001 & p = 0.03, respectively). However, there was a numerically; but not significantly, higher incidence of cardiac death (p = 0.65), and vessel thrombosis (p = 0.18) in DES arm compared to DES arm.</p><p><strong>Conclusion: </strong>In SvCAD setting, DCB has favourable angiographic and clinical outcomes; as evidenced by lower LLL and composite MACE at one year follow up, compared to DES.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of residual pulmonary congestion defined by B-line findings on lung ultrasound to predict cardiovascular events in acute heart failure: A systematic review and meta analysis.","authors":"Kevin Fernando Suhardi, Agung Prasetyo, Rahadian Malik, Pauliana, Aqsha Tiara Viazelda","doi":"10.1016/j.ihj.2025.05.003","DOIUrl":"10.1016/j.ihj.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary congestion detected by lung ultrasound (LUS) has emerged as a valuable prognostic marker in acute heart failure (AHF). This systematic review and meta-analysis aimed to evaluate the prognostic significance of residual B-lines identified by LUS before hospital discharge.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, Cochrane Library, ScienceDirect, and ClinicalTrials.gov was conducted up to October 4, 2024. Studies assessing the association between residual B-lines and adverse clinical outcomes in hospitalized AHF patients were included, while studies involving ambulatory assessments were excluded. The primary outcome was a composite of all-cause mortality and heart failure (HF) rehospitalization. Secondary outcomes included all-cause mortality and HF rehospitalization individually. Pooled hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>Fifteen studies were included. Residual B-lines were significantly associated with an increased risk of composite outcomes (HR: 2.32; 95 % CI: 1.91-2.82), all-cause mortality (HR: 3.01; 95 % CI: 1.91-4.73), and HF readmission or cardiovascular events (HR: 4.01; 95 % CI: 2.22-7.24). Risk increased with greater B-line burden. Prognostic impact was stronger in short-term follow-up (<6 months; HR: 3.57) than in longer-term follow-up (≥6 months; HR: 1.96).</p><p><strong>Conclusions: </strong>Residual pulmonary congestion assessed by LUS at discharge is a strong independent predictor of adverse outcomes and may guide therapy decisions in AHF management.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study","authors":"Sanjeev Kumar,&nbsp;Prakash Chand Negi,&nbsp;Sanjeev Asotra,&nbsp;Jitender Kumar,&nbsp;Rajeev Merwah,&nbsp;Rajesh Sharma,&nbsp;Ritesh Kumar,&nbsp;Vinay Bhardwaj,&nbsp;Preetam Singh Thakur","doi":"10.1016/j.ihj.2025.03.016","DOIUrl":"10.1016/j.ihj.2025.03.016","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with reduced ejection fraction (HFrEF) can show recovery in some patients, especially with non-ischemic causes, leading to better outcomes. Recovery varies due to factors like aetiology and severity of myocardial injury. This study examines the incidence and predictors of left ventricular ejection fraction (LVEF) recovery in non-ischemic HFrEF patients.</div></div><div><h3>Methods</h3><div>This was a prospective observational study conducted at a tertiary care hospital, involving 500 patients with non-ischemic HFrEF (baseline LVEF &lt;40 %). Patients were followed for a duration of 8 years (2011–2023) with periodic clinical assessments and annual echocardiographic evaluations. Data on comorbidities, baseline cardiac function, medication adherence, and clinical events were collected. The incidence rate of LVEF recovery was determined, and Kaplan–Meier survival analysis was used to identify recovery trends over time. Predictors of recovery were evaluated using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Cumulative incidence of LVEF recovery was 27.4 % (95 % CI: 23.7–31.5) at 8 years, with an incidence rate of 4.5 per 100 person-years. Higher baseline LVEF (≥30 %) strongly predicted recovery (HR: 2.17, p &lt; 0.001), while dilated LV (LVEDD ≥60 mm, HR: 0.6, p = 0.02) and diabetes (HR: 0.36, p = 0.01) were associated with lower recovery. Education (≥Class 5) was linked to better recovery (HR: 1.45, p = 0.04). Beta-blockers showed a potential but nonsignificant benefit<strong>.</strong></div></div><div><h3>Conclusion</h3><div>Nearly one-fourth (27.4 %) of patients achieved LVEF recovery over 8 years, with higher baseline LVEF and education associated with better outcomes, while adverse cardiac remodeling and diabetes were linked to lower recovery.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 188-192"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and one-year follow-up analysis of percutaneous ASD closure at a tertiary care hospital","authors":"Naga Raghunandan Thota,&nbsp;Kamalakar Kosaraju,&nbsp;John Satish Rudrapogu,&nbsp;Krishna Prasad Nevali,&nbsp;Thirupathi Rao Kondaveeti","doi":"10.1016/j.ihj.2025.03.011","DOIUrl":"10.1016/j.ihj.2025.03.011","url":null,"abstract":"<div><h3>Aim</h3><div>This study was designed to evaluate the safety and effectiveness of the Cocoon Septal Occluder device (Vascular Innovations Co. Nonthaburi, Thailand) for transcatheter closure of isolated secundum type atrial septal defect (ASD) in Indian patients.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective, observational study which included patients who underwent transcatheter closure of isolated secundum ASD using the Cocoon Septal Occluder between April 2014 and May 2023. Follow-up assessments up to one-year were conducted through review of hospital medical records, clinic visits, or via telephonic communication with primary care physicians.</div></div><div><h3>Results</h3><div>A total of 400 patients were included in the study, consisting of 28 paediatric (aged ≤15 years, 8.14 ± 4.41 years) and 372 adult patients (40.83 ± 13.23 years). The mean defect diameter and device size were 16.75 ± 5.85 mm and 20.43 ± 6.24 mm for paediatric patients, and 21.62 ± 6.87 mm and 24.94 ± 7.28 mm for adult patients, respectively. The device was successfully implanted in all paediatric patients, achieving 100 % closure of the defect with no complications, which persisted through one-year follow-up. In the adult cohort, complete ASD closure was achieved in 99.2 % of patients, with two cases of device embolization and one case of device withdrawal. At one-year follow-up, adult patients experienced 0.3 % late device embolization, 0.8 % pericardial effusion/cardiac tamponade, 0.5 % atrioventricular block, and 0.5 % atrial flutter/fibrillation. No cases of endocarditis, haemolysis, nickel allergy, stroke/transient ischemic attack, or migraine were reported in either paediatric or adult patients.</div></div><div><h3>Conclusion</h3><div>The results demonstrate that Cocoon Septal Occluder is safe and effective in closing isolated secundum ASD during one-year follow-up.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 199-203"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of post myocardial infarction ventricular septal rupture: Experience from an Indian tertiary cardiac center","authors":"Pramod Sagar ,&nbsp;Raghuram Chikkala ,&nbsp;Sridhara Suthan ,&nbsp;Aayisha Nasser ,&nbsp;Kothandam Sivakumar ,&nbsp;Rajan Sethuratnam ,&nbsp;Valikapthalil Mathew Kurian ,&nbsp;Mullasari Sankardas Ajit","doi":"10.1016/j.ihj.2025.05.002","DOIUrl":"10.1016/j.ihj.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Post myocardial infarction ventricular septal rupture (MI-VSR) is a devastating complication after acute myocardial infarction (AMI); lacks uniform treatment recommendations and carries poor outcomes.</div></div><div><h3>Objectives</h3><div>To evaluate the outcomes of post MI-VSR, stratify based on management strategy and determine the predictors of survival.</div></div><div><h3>Methods</h3><div>All cases of VSR hospitalized in a tertiary referral cardiac care center over 11 years were retrospectively evaluated for various parameters and stratified based on the modality of treatment, either conservative, surgical or transcatheter closure.</div></div><div><h3>Results</h3><div>Among a total of 131 cases of VSR with a median age of 65 years, hospitalized from January 2013 to December 2023, 47(35.9 %) had surgical closure, 25(19.1 %) had transcatheter closure and the rest were managed conservatively. 11(8.4 %) cases alone underwent primary percutaneous coronary intervention (PCI). Apex was the commonest (79.3 %) site. Older patients and patients in higher stages of shock at the time of VSR diagnosis were often managed conservatively. Two-thirds of surgical patients were in SHOCK stage A or B; three-fourths of transcatheter group were in stage C or D. Overall mortality was 71 % with 100 % in conservative, 68 % in transcatheter closure and 36.2 % in surgical group. Younger age, lower shock stage, VSR closure, and delayed closure were predictors of survival.</div></div><div><h3>Conclusions</h3><div>Post MI VSR outcomes were poor, based on the hemodynamic status. Closure of VSR is essential for survival. Surgical closure had lower mortality than transcatheter closure possibly contributed by a selection bias.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 151-158"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}