[Posterior ventricular septal perforation successfully repaired through right ventricular approach]

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Cardiac Pathology

Background:

• Posterior ventricular septal perforation (VSP) is a rare but serious complication of acute myocardial infarction.
• Delayed surgical repair is often associated with poor outcomes due to hemodynamic instability.

Observation:

• A 65-year-old male presented with worsening hemodynamics 9 days post-myocardial infarction.
• An emergent surgical intervention was performed to address a 5 mm posterior VSP.

Findings:

• Successful repair of the posterior VSP was achieved using an equine pericardial patch and a double-patch technique.
• Postoperative evaluation showed no residual shunt and good cardiac function.
• The patient was discharged on postoperative day 20 with stable hemodynamics.

Implications:

• This case demonstrates the feasibility of successful VSP repair even in the acute post-infarction period.
• The double-patch technique may offer a viable option for complex VSP repairs.
• Further research is warranted to improve outcomes for acute VSP patients.