Ventricular Septal Defects After Myocardial Infarction

Abstract

Twelve patients underwent emergency operative closure of a ventricular septal defect (VSD) occurring as a complication of acute myocardial infarction. Operations were performed an average of eight days following infarction, and five days after the appearance of the VSD. All patients were in cardiogenic shock or intractable congestive heart failure. Operative repair involved closure of the septal defect with the use of a Teflon patch and pledgets for support. In addition, an infarctectomy or aneurysmectomy was performed in most of the survivors. Six patients are alive 6 to 54 months after operation (average, 22 months). Successful early operative closure of a postinfarction VSD can be accomplished, with an encouraging survival rate. The major factor determining survival was the function of the remaining myocardium.