Repair of postinfarction septal rupture

Postinfarction rupture of the interventricular septum was recognized in the middle of the nineteenth century, and Cooley et al. reported the first surgical repair in 1957. The first long-term survivor of surgical repair of postinfarction ventricular septal defect (VSD) had the operation at the Mayo Clinic in 1963 by Dr. John W. Kirklin. Since these earlier efforts, the surgical management of postmyocardial infarction VSD has changed from an operation reserved for patients who survived several weeks or months after the septal rupture (usually performed through a right ventriculotomy), to an emergency operation in the majority of cases. Although many advances in medical and surgical management have improved operative results, surgical repair of postinfarction septal rupture still is an exigent procedure.