Ruptured Interventricular Septum

Abstract

RUPTURE of the interventricular septum is an uncommon but usually lethal complication of acute myocardial infarction. It is estimated that 1% to 2% of deaths attributable to acute myocardial infarction are associated with septal perforation. The average interval between septal rupture and death is 2 weeks, with 50% of the deaths occurring within the first week. Only 3 patients with this lesion are known to have survived more than 5 years. Until recently, the only treatment available for septal rupture consisted of those measures commonly employed in the treatment of congestive heart failure. Cooley was the first to suggest the surgical closure of interventricular septal rupture with utilization of cardiopulmonary bypass. He closed a 3- × 2-cm. septal defect in a 49-year-old man 11 weeks after infarction. The patient showed remarkable improvement for a few weeks but died of sepsis on the 45th postoperative day. Shickman et al. reported the