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January 1959

Repair of Ruptured Interventricular Septum Complicating Acute Myocardial Infarction

Author Affiliations

Los Angeles

From the Departments of Medicine and Surgery, Wadsworth General Hospital, Veterans Administration Center, and the Department of Medicine, University of California School of Medicine. Senior Resident in Cardiology, Veterans Administration Center, and Clinical Assistant in Medicine, University of California School of Medicine (Dr. Shickman); Section Chief, Thoracic Surgery, Veterans Administration Center, and Research Cardiologist, University of California School of Medicine (Dr. Fields); Chief, Cardiology Section, Veterans Administration Center, and Associate Professor of Medicine (in residence), University of California School of Medicine (Dr. Pearce).

AMA Arch Intern Med. 1959;103(1):140-145. doi:10.1001/archinte.1959.00270010146019

Rupture of the interventricular septum following myocardial infarction is being reported with increasing frequency both in autopsy material and as an antemortem diagnosis.1-5 While the prognosis is uniformly poor, extended survivals are frequent enough 6 to warrant the consideration of corrective surgery. In one reported case,7 repair was accomplished through an open cardiotomy aided by a pump oxygenator. At the present time it would seem desirable, in these high-risk patients, to attempt repair by a surgical procedure which avoids the added time and risk of an artificial circulation. The perforations secondary to infarction usually occur in the apical portion of the septum, often adjacent to one of the free ventricular walls.6,8 A fairly rapid repair of these defects thus seems feasible, avoiding the additional hazards of a pump oxygenator. The following case report describes such a surgical approach in a patient in whom rupture of the interventricular