The percutaneous cardiopulmonary support system (PCPS) was used in a 75-year-old female with a blow out type heart rupture of the posterior wall complicating acute myocardial infarction. The patient was transported to the operating room with the PCPS and IABP in place, and had the ventricular rupture repaired as well as CABG. Although the postoperative cardiac function was satisfactory she sustained ischemic cerebral stroke and went on to die of aspiration pneumonia 166 day later. PCPS buys time to enable surgical repair of the heart, but how to protect the brain remains as a problem to be solved.