Postinfarction ventricular septal defect: delayed closure with prolonged mechanical circulatory support.

Three patients who had ventricular septal rupture and cardiogenic shock complicating an acute myocardial infarction were treated by prolonged circulatory assistance using intraaortic balloon pumping. Hemodynamic stabilization was obtained, and surgical repair was delayed for 19 to 27 days after initiation of circulatory support. All three patients survived the operation and were discharged from the hospital 13 to 19 days after operation. Prolonged intraaortic balloon pumping in such patients is safe and often induces hemodynamic stabilization. The patients may then be operated on under more favorable conditions, without risk of multisystem failure, and after fibrosis has developed around the septal rupture.