Myocardial to occur in approximately 10% of people dying of myocardial infarction, and of these, 12% are associated with perforation of the interventricular septum.1,2 There are more than 250 cases of septal rupture described in the literature; however, less than 15% of these patients have survived more than two months after perforation.3 To date approximately 20 patients have been treated surgically.4-6 Although the mortality is quite high, earlier and more frequent surgical intervention has been suggested to improve the prognosis.
The following report documents the successful repair of a ventricular septal defect which occurred during the course of an acute myocardial infarction. The clinical manifestations and present criteria for management of these patients are reviewed.
A 48-year-old aircraft mechanic was admitted to a nearby hospital on May 8, 1967, following two to three hours of severe chest pain, breathlessness, and diaphoresis. He had an 18-year