Management of recurrent leaks following postinfarction ventricular septal defect repairs

Abstract

Ventricular septal rupture (VSR) complicates acute myocardial infarction (AMI) in less than 0.2% of cases and is usually surgically managed by endocardial patch repair with infarct exclusion. Although successful in 80% of cases, failure of patch repair (often because of patch dehiscence) results in attempts at percutaneous closure as reoperative mortality can be as high as 40%. We describe a case of an AMI in a 63-year-old male with resultant VSR that required repeat surgical patch repair secondary to recurrent leak. We discuss the management of recurrent leaks and surgical techniques aimed at decreasing residual defects.