Diagnosis and Definitions
VSR was defined as (1) the appearance of rough blowing systolic murmurs
between the third and fourth left ribs during post-AMI physical
examinations; (2) loss of interventricular septum echo on
echocardiography, and the presence of a left-to-right shunt; and (3) VSR
identified by left ventriculography as indicated by left-to-right
shunting of the contrast agent.
Rupture size (Dmax): The preoperative maximum value of defect diameter
in mm, measured by transthoracic ultrasound.
Dmin: The preoperative minimum value of defect diameter in mm, measured
by transthoracic ultrasound.
Rupture enlargement (ΔD): ΔD=Dmax-Dmin
Rupture enlargement rate (ΔDR): ΔDR=ΔD/T, T: The minimum time interval
between Dmax and Dmin, in days (d).
Critical preoperative status: preoperative severe hemodynamic
instability requiring IABP implantation or emergency surgery.