Ventricular septal rupture secondary to myocardial infarction. Clinical approach and surgical results.

Twenty-four patients underwent operation for ventricular septal rupture secondary to acute myocardial infarction. There were 14 hospital survivors (58%) and two late deaths (8%). There were eight hospital deaths (62%) of 13 patients referred in cardiogenic shock, but only two deaths (18%) of 11 patients not in shock at time of referral. All 12 current survivors showed clinical improvement, and 11 of them are in New York Heart Association functional class I or II. Eleven patients had bedside catheterization with a balloon catheter and were operated on immediately thereafter, and eight survived (73%) with no late deaths at five years. With formal heart catheterization followed by operation, there were only six survivors of 13 operated on (46%).