Emergency Surgical Repair of Post Infarction Ventricular Septal Rupture Case Report

Ventricular septal rupture (VSR) is a life-threatening complication of trans-mural acute myocardial infarction (MI). Surgical intervention remains the treatment of choice, but it is still a challenging operation associated with high mortality (1). VSR is a rare serious complication of MI. Its incidence has been estimated between 1%¬ - 2% after MI. If it treated medically the mortality is very high (25% in 1st day, 75% at 1st week and 90% at 2 months). Patients that survive following medical treatment usually have clinically poor cardiac function. So, the result of medical treatment of VSR is disappointing (2). Primary PCI following MI can be significantly reduced the incidence of mechanical complications. However, with improving treatment, appropriate management of mechanical complications remains a cornerstone to avoid low cardiac output (LCO) and multi organ failure (MOF). Medical treatment has high failure and mortality rate, and early surgical ventricular septal defect (VSD) closure is recommended to reverse the hemodynamic deterioration. However, surgical repair is associated to a high rate of mortality (20% –40%) even in the more recent reports (3). Transcatheter device closure of VSR, is an option, however it is generally accepted to be inadequate. Progressive deterioration in hemodynamic status makes surgical intervention often the only realistic option (4).