Post–myocardial infarction ventricular septal rupture at a Pakistani tertiary cardiac center: documented short-term outcomes, management patterns, and unadjusted bivariable correlates in a retrospective observational cohort.
DOI:
https://doi.org/10.58889/PJCVI.6.1.03.14Keywords:
Ventricular Septal Rupture, Myocardial Infarction, Mortality, Retrospective Observational Cohort, Mechanical Complications, PakistanAbstract
Background: Post–myocardial infarction (MI) ventricular septal rupture (VSR) remains a devastating mechanical complication of acute MI, with persistently high mortality despite advances in reperfusion and structural cardiac intervention. In low- and middle-income settings, delayed presentation, referral barriers, and limited access to definitive repair may further affect outcomes. This study aimed to describe short-term outcomes, management patterns, and unadjusted bivariable correlates of confirmed outcome among patients with post-MI VSR at a tertiary cardiac center in Pakistan.
Methodology: This retrospective observational cohort study included consecutive patients with echocardiography-confirmed post-MI VSR presenting to the Peshawar Institute of Cardiology between January 1, 2023, and December 31, 2024. Data were abstracted from hospital records, discharge summaries, echocardiography reports, procedural documentation, and available follow-up records. Outcome status was classified as documented death, documented discharge/survival, or uncertain outcome.
Results: Among 51 patients, 20 (39.2%) had documented death, 15 (29.4%) had documented discharge alive or survival, and 16 (31.4%) had uncertain outcomes. Median age was 65.0 years [IQR, 59.5–71.0], and 22 (43.1%) were female. Hypertension, diabetes, and anterior MI were common. Most patients had no definitive repair documented (44/51, 86.3%). Among 35 patients with confirmed outcomes, no variable showed a statistically robust unadjusted association with short-term outcome.
Conclusion: Post-MI VSR was associated with substantial early mortality in this Pakistani cohort. However, incomplete follow-up and limited physiologic data restricted interpretation. Findings are exploratory and support the need for prospective multicenter studies with standardized follow-up.
