Mechanical complications following acute myocardial infarction.

OBJECTIVE To outline the outcome and management of patients with acute myocardial infarction presenting with mechanical complications such as post-infarction ventricular septal defect, mitral regurgitation and left ventricular rupture. METHODS The retrospective study, conducted in September and October, 2010 at the Aga Khan University Hospital, Karachi, included cases from January 1990 to December 2009. Only 18 cases were found who had presented with such complications. They were assessed for demographics as well as pre-operative, per-operative and post-operative management patterns. Data was analysed using SPSS version 17.0. RESULTS Out of the 18 patients, 10 had post-infarction ventricular septal defect, while 8 had mitral regurgitation defects. The mean time from myocardial infarction to the diagnosis of mechanical complications was 5.28 +/- 4.07 days, and from diagnosis to repair was 2.00 +/- 1.49 days. Overall, there were 3 in-hospital mortalities. CONCLUSION The optimal timing of surgical intervention has always remained debatable. A high-level of clinical suspicion and earlier intervention can reduce morbidities and mortalities.