Surgical Repair of Ventricular Septal Rupture and Ventricular Aneurysm

A successful surgical repair of a ruptured ventricular septum and resection of a left-ventricular aneurysm secondary to myocardial infarction was performed on a 76-year-old man. A review of the literature reveals that eight other patients with ventricular septal rupture and ventricular aneurysm underwent surgical treatment. Longer survival and better results correlated somewhat with younger age, higher systemic cardiac output, higher pulmonary artery pressure, concomitant aneurysmectomy, and an interval of three months or more between septal rupture and its repair. However, notable exceptions to each situation exist. The data suggest that patients with these complications undergo surgical treatment when nonoperative treatment is no longer effective; otherwise, elective repair should be carried out three months after the rupture. In either case, concomitant aneurysmectomy is advised.