A 67-year-old man presented with late left ventricular free wall rupture 1 month after an extended sandwich technique through a right ventricular incision for ventricular septal rupture following an inferoposterior acute myocardial infarction. We found that residual infarcted myocardium had led to left ventricular aneurysm formation. A pericardial patch on the left ventricular side at the initial operation should have been secured further from the septal defect using a larger needle. A patch on the left ventricular side is important for complete exclusion of a free wall infarction and for decreasing the stress on the suture line securing the patch.
Keywords: Heart rupture; Heart ventricles; Postoperative complications; Renal insufficiency; Shock; cardiogenic; post-infarction.