{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:18:38Z","timestamp":1787872718559,"version":"build-2784847793"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acquired ventricular septal defect (VSD), typically following myocardial infarction (MI) or infective endocarditis (IE), remains a rare but life-threatening condition. Surgical repair represents the standard of care, yet data on long-term outcomes and health-related quality of life (HRQoL) are limited.<\/jats:p>\n                  <jats:p>We retrospectively analyzed 44 consecutive patients (median age 65 years, interquartile range [IQR] 57\u201372.5; range 20\u201383) who underwent surgical VSD closure at our institution between 2008 and 2023. Clinical characteristics, perioperative variables, and outcomes were assessed according to defect etiology and survival status. Long-term survival was assessed using Kaplan\u2013Meier analysis. HRQoL among survivors was evaluated with the European Quality of Life-5-Dimensions-5-Level Version (EQ-5D-5L) questionnaire.<\/jats:p>\n                  <jats:p>Post-MI VSD accounted for 65.9% of cases, and IE-related VSD for 20.5%. Preoperative cardiogenic shock was present in 52.3%. Overall, 30-day mortality was 34.1% (MI-VSD 46.4%, IE-VSD 22.2%). Non-survivors were older (69.2 vs. 60.8 years, p\u2009=\u20090.015), more frequently in shock (80.0% vs. 37.9%, p\u2009=\u20090.013), and experienced more postoperative complications per patient (1.9 vs. 0.4, p\u2009=\u20090.001). Median follow-up among survivors was 10.7 years (IQR 6.6\u201313.8; range 2.0\u201317.2). Kaplan\u2013Meier survival at 2 and 5 years was 61.4% and 56.8%, respectively. HRQoL was generally preserved, with favorable mental and social domain scores (e.g., anxiety\/depression: mean 1.6\/5) and acceptable physical functioning (e.g., pain\/discomfort: mean 1.9\/5). Younger age at repair and longer follow-up were associated with higher HRQoL.<\/jats:p>\n                  <jats:p>Despite substantial perioperative mortality\u2014particularly in post-MI VSD and hemodynamically unstable patients\u2014surgical closure provides durable long-term survival with overall satisfactory HRQoL in survivors.<\/jats:p>","DOI":"10.1055\/a-2894-6436","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T23:01:36Z","timestamp":1781564496000},"page":"492-499","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Repair of Acquired Ventricular Septal Defects: Outcomes and Quality of Life"],"prefix":"10.1055","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8855-3243","authenticated-orcid":false,"given":"Henrik","family":"Heuer","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiothoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Truong","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Vascular Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kostiantyn","family":"Kozakov","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiothoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric","family":"van Sprang","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiothoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schach","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozef","family":"Micek","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Vasin","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiothoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Petermichl","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Anesthesiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Camboni","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiothoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Schmid","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Cardiothoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"University Medical Center Regensburg, Bavaria, Germany","place":["Regensburg"],"department":["Department of Occupational Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,21]]},"reference":[{"issue":"18","key":"ref1","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1056\/NEJMra020228","article-title":"Ventricular septal rupture after acute myocardial infarction","volume":"347","author":"Y Birnbaum","year":"2002","journal-title":"N Engl J Med"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.athoracsur.2012.04.020","article-title":"Surgical repair of ventricular septal defect after myocardial infarction: outcomes from the Society of Thoracic Surgeons National Database","volume":"94","author":"G J Arnaoutakis","year":"2012","journal-title":"Ann Thorac 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A Clinical Consensus Statement of the Association for Acute CardioVascular Care (ACVC) of the ESC, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the ESC Working Group on Cardiovascular Surgery","volume":"45","author":"F Schlotter","year":"2024","journal-title":"Eur Heart J"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/eurheartj\/ehn524","article-title":"Immediate primary transcatheter closure of postinfarction ventricular septal defects","volume":"30","author":"H Thiele","year":"2009","journal-title":"Eur Heart J"},{"issue":"10","key":"ref18","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.jcin.2021.02.046","article-title":"Mechanical circulatory support as a bridge to definitive treatment in post-infarction ventricular septal rupture","volume":"14","author":"D Ronco","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"325","DOI":"10.21037\/acs-2021-ami-21","article-title":"The use of mechanical circulatory support in post-acute myocardial infarction mechanical complications","volume":"11","author":"R Lorusso","year":"2022","journal-title":"Ann Cardiothorac Surg"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1749-8090-4-3","article-title":"Experiences with surgical treatment of ventricle septal defect as a post infarction complication","volume":"4","author":"K O Coskun","year":"2009","journal-title":"J Cardiothorac Surg"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"e278","DOI":"10.1097\/MAT.0000000000001873","article-title":"Impella support for surgical ventricular septal defect repair","volume":"69","author":"E Ruiz Duque","year":"2023","journal-title":"ASAIO J"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1055\/a-2607-6390","article-title":"Delayed sternal closure in heart surgery: outcomes and quality of life","volume":"74","author":"H Heuer","year":"2026","journal-title":"Thorac Cardiovasc Surg"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s13054-025-05321-x","article-title":"ICU mortality of post-myocardial infarction ventricular septal defect complicated by cardiogenic shock: A retrospective multicentric cohort","volume":"29","author":"L-D Azoulay","year":"2025","journal-title":"Crit Care"},{"issue":"08","key":"ref24","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1055\/s-0033-1342942","article-title":"Survival, functional capacity, and quality of life after cardiac surgery followed by long-term intensive care stay","volume":"61","author":"H Deschka","year":"2013","journal-title":"Thorac Cardiovasc Surg"},{"issue":"07","key":"ref25","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1097\/00003246-200107000-00018","article-title":"Functional status and quality of life in long-term survivors of cardiac arrest after cardiac surgery","volume":"29","author":"I Dimopoulou","year":"2001","journal-title":"Crit Care Med"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2894-6436.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:48:30Z","timestamp":1787870910000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2894-6436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":25,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2026,8,27]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2894-6436","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6,15]]},"published":{"date-parts":[[2026,6,15]]}}}