A 61-year-old man presented by ambulance with dyspnea. He was diagnosed with myocardial infarction complicated with ventricular septal perforation (VSP), and intraaortic balloon pumping support and intensive care were started. Because of instability of hemodynamic status, modified David-Komeda operation with double patch was performed in the subacute phase of VSP. Although he developed acute respiratory distress syndrome( ARDS) on the 21st day after operation, he was successfully treated with corticosteroid pulse therapy and artificial ventilation. He was transferred to a rehabilitation hospital on the 141st postoperative day.