Successful treatment of ischaemic VSD and acute RV failure: a challenging case in the modern NHS.

A 52-year-old man, previously fit and well, presented with myocardial infarction complicated by ischaemic ventricular septal defect (VSD) and acute right ventricular failure, was successfully treated with early percutaneous coronary reperfusion, surgical VSD repair and temporary right ventricular assist device (VAD) support. This case is an example of how a modern healthcare system can successfully manage complex emergency cases, combining high levels of clinical care and medical technology. Access to temporary mechanical support played a vital role in this case. We believe that wider access to VADs may contribute to improvement in the, widely recognised, poor outcome of ischaemic VSD.