IN RECENT years the antemortem diagnosis of perforation of the ventricular septum following myocardial infarction has become more common. Most of these patients die due to either a sudden arrhythmia or intractable congestive failure. Surgical intervention in this acquired defect has become possible since the development of open cardiac surgery. A brief review of the English literature shows 14 attempts at surgical closure of the septal defect. There are, however, no clear cut indications for surgical intervention. The time of intervention and the condition of the myocardium at that time are clearly the factors which determine the results. The purpose of this paper is to describe the successful repair of a ruptured ventricular septum following myocardial infarction in a patient who could not be gotten out of intractable congestive failure by more conservative means.
Report of Case
On or about March 1, 1965, a 55-year-old man experienced sudden pain in