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January 2020 Br J Cardiol 2020;27:34–6 doi:10.5837/bjc.2020.004

Successful treatment of ischaemic ventricular septal defect and acute right ventricular failure: a challenging case in the modern NHS

Renata Greco, Andrew Johnson, Xy Jin, Rajesh K Kharabanda, Adrian P Banning, Mario Petrou

Abstract

Introduction Post-myocardial infarction VSD is an uncommon but frequently fatal complication, occurring in less than 1% of patients sustaining myocardial infarction (MI) in the modern era of early reperfusion therapy. Despite significant improvements over the last two decades in overall mortality for acute MI, the outcome of patients who develop VSD remains poor. Mortality rates exceed 90% with medical therapy.1,2 Data from the Society of Thoracic Surgeons (STS) registry (2,876 patients) showed an overall operative mortality of 42.9%, representing the highest risk of all cardiac procedures recorded in the database. Mortality was higher (54.1%

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