ICU mortality of post-myocardial infarction ventricular septal defect complicated by cardiogenic shock: a retrospective multicentric cohort

Azoulay, LD; Bagate, F; Delmas, C; Paulus, S; Mongardon, N; Abou-Arab, O; Squara, P; Habis, M; Nougue, H; Morichau-Beauchant, T; Kimmoun, A; Seemann, A; Radu, C; de Roux, Q; Treille de Grandsaigne, H; Fellahi, JL; Beyls, C; Cholley, B; Klein, T; Gaillet, A; Mekontso Dessap, A; French PMI-VSD-Shock Study Group (FPSG)

doi:10.1186/s13054-025-05321-x

Hemodynamics, fluids & transfusion

ICU mortality of post-myocardial infarction ventricular septal defect complicated by cardiogenic shock: a retrospective multicentric cohort

Crit CarePublished 18 Mar 2025Retrospective cohort study

Read the original article ↗PubMed

Cite

Authors' conclusion

Delayed VSD closure is associated with improved outcomes in PMI-VSD complicated by cardiogenic shock.

Study context

Population: Patients with post-MI ventricular septal defect (post myocardial infarction ventricular septal defect (PMI-VSD)) complicated by cardiogenic shock, 10 French tertiary centers, 2008–2022
Participants: 138 patients · 10 French centres

Exposure: Surgical management strategy: no surgery vs early vs late VSD surgery
Early surgeryn = 60
Late surgeryn = 33
Outcome: In-ICU mortality

Methodological detailsmulticentre, multivariable analysis, 116 (84%) received MCS, incl. 43 (31%) VA-ECMO; 93 (67%) surgical closure; 2 percutaneous closure without surgery

Multicentre
Multivariable analysis
116 (84%) received MCS, incl. 43 (31%) VA-ECMO; 93 (67%) surgical closure; 2 percutaneous closure without surgery

Main finding

As reported in the abstract

No surgery100%

Early surgery45%

Late surgery27%

Multivariable, all patients

Adjusted odds ratio (95% CI)P value

Old age

1.1(1.02–1.12.)

P = 0.004

SOFA score

1.2(1.07.–1.37)

P = 0.003

VA-ECMO

2.9(1.2–7.7)

P = 0.02

Overall in-ICU deaths: 84 (61%)
Surgical management strategy associated with in-ICU mortality (ptrend): P for trend < 0.001

Observational data: associations, not effects.

Further findings

Longer delay ICU admission to VSD surgical closure and in-ICU mortality (surgical closure subgroup)

	← Lower odds ←→ Higher odds →	aOR (95% CI)	P value
Longer delayMultivariable analysis	0.512	0.9 (0.79–0.96)	P = 0.003
	0.512Adjusted odds ratio (log scale)

Variables independently associated with in-ICU mortality (all patients)

Multivariable analysis

Original publication

ICU mortality of post-myocardial infarction ventricular septal defect complicated by cardiogenic shock: a retrospective multicentric cohort. Crit Care. Published 18 March 2025. doi:10.1186/s13054-025-05321-x

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →