Key result
A patient with a ventricular septal perforation complicating an acute myocardial infarction survived for 14 years with conservative medical management and remained in NYHA functional class I.
Case Report (n=1)
No
This case demonstrates that extremely long-term survival (14 years) is possible with conservative management in a patient with post-myocardial infarction ventricular septal perforation if they are hemodynamically stable with a small left-to-right shunt.
May support conservative management in select stable post-MI VSP cases; leaves open broader applicability and selection criteria.
We treated a case of ventricular septal perforation (VSP) who survived for 14 years after myocardial infarction. Nine years after the onset of myocardial infarction, an apparent cardiac murmur was discovered by chance, and following further examination, the patient was diagnosed as having VSP. The patient is still in the NYHA functional class I, and requiring no surgical treatment. In general, the prognosis of myocardial infarction complicated with VSP is so poor that there have only been 14 reported cases of long survival without surgical treatment. Among these patients, only 2 survived for more than 10 years. The present case is extremely rare, and evidently is the longest living survivor with this condition yet reported.
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Suetsugu et al. (2000) conducted a case report in Ventricular septal perforation after myocardial infarction (n=1). Conservative medical management was evaluated on Survival. A patient with a ventricular septal perforation complicating an acute myocardial infarction survived for 14 years with conservative medical management and remained in NYHA functional class I.
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