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British Heart Journal logoLink to British Heart Journal
. 1989 Oct;62(4):268–272. doi: 10.1136/hrt.62.4.268

Patterns of coronary artery disease in post-infarction ventricular septal rupture.

J D Skehan 1, C Carey 1, M S Norrell 1, M de Belder 1, R Balcon 1, P G Mills 1
PMCID: PMC1277362  PMID: 2803872

Abstract

Cardiac angiography was reviewed in 91 patients with post-infarction ventricular septal rupture. The results were compared with those of 123 stable survivors who had a positive submaximal exercise test early after infarction. Anterior infarction and occlusion of the infarct vessel were more common in those with ventricular septal rupture than in the comparison group. In the group with ventricular septal rupture there was more left ventricular damage, with aneurysm formation in two thirds, and coronary angiography showed more single than triple vessel disease. In the comparison group there was more triple vessel disease than single vessel disease. Angiographically demonstrable collaterals to the infarct territory were not seen or only very faintly seen in 82% of those with septal rupture. Well developed collaterals were seen in two thirds of the comparison group. These patterns of coronary disease suggest that ventricular septal rupture is more likely in patients with coronary occlusion and little or no collateral support to the infarct territory.

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Selected References

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  1. Bosch X., Théroux P., Waters D. D., Pelletier G. B., Roy D. Early postinfarction ischemia: clinical, angiographic, and prognostic significance. Circulation. 1987 May;75(5):988–995. doi: 10.1161/01.cir.75.5.988. [DOI] [PubMed] [Google Scholar]
  2. CARLETON R. A., BOYD T. Traumatic laceration of the anterior descending coronary artery treated by ligation without myocardial infarction: report of a case with review of the literature. Am Heart J. 1958 Jul;56(1):136–142. doi: 10.1016/0002-8703(58)90173-x. [DOI] [PubMed] [Google Scholar]
  3. Carroll R. J., Verani M. S., Falsetti H. L. The effect of collateral circulation on segmental left ventricular contraction. Circulation. 1974 Oct;50(4):709–713. doi: 10.1161/01.cir.50.4.709. [DOI] [PubMed] [Google Scholar]
  4. Fox A. C., Glassman E., Isom O. W. Surgically remediable complications of myocardial infarction. Prog Cardiovasc Dis. 1979 May-Jun;21(6):461–484. doi: 10.1016/0033-0620(79)90026-4. [DOI] [PubMed] [Google Scholar]
  5. Kim S. G. The management of patients with life-threatening ventricular tachyarrhythmias: programmed stimulation or Holter monitoring (either or both)? Circulation. 1987 Jul;76(1):1–5. doi: 10.1161/01.cir.76.1.1. [DOI] [PubMed] [Google Scholar]
  6. Kolibash A. J., Bush C. A., Wepsic R. A., Schroeder D. P., Tetalman M. R., Lewis R. P. Coronary collateral vessels: spectrum of physiologic capabilities with respect to providing rest and stress myocardial perfusion, maintenance of left ventricular function and protection against infarction. Am J Cardiol. 1982 Aug;50(2):230–238. doi: 10.1016/0002-9149(82)90171-0. [DOI] [PubMed] [Google Scholar]
  7. Loisance D. Y., Cachera J. P., Poulain H., Aubry P., Juvin A. M., Galey J. J. Ventricular septal defect after acute myocardial infarction: Early repair. J Thorac Cardiovasc Surg. 1980 Jul;80(1):61–67. [PubMed] [Google Scholar]
  8. MacLeod D., Fananapazir L., de Bono D., Bloomfield P. Ventricular septal defect after myocardial infarction: assessment by cross sectional echocardiography with pulsed wave Doppler scanning. Br Heart J. 1987 Sep;58(3):214–217. doi: 10.1136/hrt.58.3.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Norell M. S., Gershlick A. H., Pillai R., Walesby R., Magee P. G., Wright J., Layton C., Balcon R. Ventricular septal rupture complicating myocardial infarction: is earlier surgery justified? Eur Heart J. 1987 Dec;8(12):1281–1286. doi: 10.1093/oxfordjournals.eurheartj.a062214. [DOI] [PubMed] [Google Scholar]
  10. Siepser S. L., Kaltman A. J., Mills N., Pughkem T., Fox A. C. Coronary collateral flow after traumatic fistula between right coronary artery and right atrium. N Engl J Med. 1972 Oct 12;287(15):754–756. doi: 10.1056/NEJM197210122871507. [DOI] [PubMed] [Google Scholar]
  11. WESSLER S., ZOLL P. M., SCHLESINGER M. J. The pathogeneis of spontaneous cardiac rupture. Circulation. 1952 Sep;6(3):334–351. doi: 10.1161/01.cir.6.3.334. [DOI] [PubMed] [Google Scholar]
  12. de Belder M. A., Pumphrey C. W., Skehan J. D., Rimington H., al Wakeel B., Evans S. J., Rothman M., Mills P. G. Relative power of clinical, exercise test, and angiographic variables in predicting clinical outcome after myocardial infarction: the Newham and Tower Hamlets study. Br Heart J. 1988 Nov;60(5):377–389. doi: 10.1136/hrt.60.5.377. [DOI] [PMC free article] [PubMed] [Google Scholar]

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