@article{oai:dmu.repo.nii.ac.jp:00005264,
 author = {Shibasaki, Ikuko and Ogawa, Hironaga and Masawa, Taito and Takei, Yusuke and Seki, Masahiro and Kato, Takashi and Saito, Shunsuke and Kuwata, Toshiyuki and Yamada, Yasuyuki and Toyoda, Shigeru and Fukuda, Hirotsugu},
 issue = {3},
 journal = {Dokkyo Medical Journal},
 month = {Sep},
 note = {The optimal timing of acute myocardial infarction-associated ventricular septal rupture surgery is controversial. Therefore, we examined the appropriateness of our ventricular septal rupture surgical strategy for early surgery in absence of organ failure and delayed surgery after organ failure recovery. We retrospectively included 22 patients who underwent surgery for ventricular septal rupture between January 2012 and February 2021. After diagnosis, patients without organ failure underwent early surgery; those with organ failure underwent delayed surgery after organ failure recovery. In the early- (n = 17) and delayed-surgery (n = 5) groups, the mean ± standard deviation time from diagnosis to surgery was 0.3 ± 0.7 (0-2) and 5.2 ± 2.3 (3-8) days, respectively. The early-surgery group was treated with preoperative mechanical circulatory support using an intra-aortic balloon pump. The delayed-surgery group was treated with an Impella (n = 1), intra-aortic balloon pump combined with venous artery extracorporeal membrane oxygenation (n = 1), and Impella combined with venous artery extracorporeal membrane oxygenation (ECpella) (n = 3). The hospital and mid-term (52.1 ± 42.9 months) mortality rates were 9.1% (early-surgery group, 11.8%; delayed-surgery group, 0%) and 18.2% (early-surgery group, 23.5%; delayed-surgery group, 0%), respectively. Further, 70.6% and 82.4% patients without organ failure had cardiogenic shock and an anterior rupture location, respectively. In the early-surgery group, combined treatment with an intra-aortic balloon pump and medical therapy yielded hemodynamic stability until surgery. However, in patients with organ failure requiring long-term management, ECpella therapy was preferable, depending on the rupture size. Our treatment strategy was reasonable. Further research is warranted to determine the optimal support duration, especially for patients requiring long-term management.},
 pages = {235--246},
 title = {Timing of Surgery under Mechanical Circulatory Support for Ventricular Septal Rupture Due to Acute Myocardial Infarction},
 volume = {1},
 year = {2022}
}