Cor Vasa 2025, 67(5):597-600 | DOI: 10.33678/cor.2025.067

Surgical Management and Postoperative Outcomes of Ventricular Septal Rupture Following Acute Myocardial Infarction: A Case Series

Daud Yudhistira Sukanto, Yan Efrata Sembiring, Oky Revianto

Department of Thoracic, Cardiac, and Vascular Surgery Dr. Soetomo General Academic Hospital, Faculty of Medicine-Universitas Airlangga, Surabaya, Indonesia

Introduction: Ventricular septal rupture (VSR) is a rare but life-threatening complication of acute myocardial infarction (AMI), occurring in approximately 0.2% of post-AMI cases. Surgical repair is the definitive treatment, it carries a high mortality risk, particularly when performed emergently.

Aim: To present a case series of five patients with VSR following AMI and evaluate their surgical management and postoperative outcomes at Dr. Soetomo General Hospital Methods: A retrospective analysis was conducted on five male patients, aged 44 to 63 years, diagnosed with VSR post-AMI between 2023 and 2024. Patient demographics, VSR characteristics, surgical interventions, and postoperative outcomes were systematically reviewed. The management strategy prioritized emergent surgical repair in hemodynamically unstable patients, supplemented by intensive postoperative care.

Results: VSR sizes ranged from 0.55 cm to 3.0 cm, predominantly located in the apical region. Four of the five patients survived, while one patient experienced fatal complications, including cardiogenic shock, non-sustained ventricular tachycardia, hospital-acquired pneumonia, and acute kidney injury on postoperative day 10. Postoperative complications included acute kidney injury (in four patients), cardiogenic shock, and pleural effusion. Hospital stays varied from 8 to 16 days, with one patient requiring intra-aortic balloon pump support.

Conclusion: Early surgical intervention is critical in managing post-AMI VSR, with precise timing and careful patient selection essential for improving outcomes. Intensive postoperative management is pivotal in mitigating complications and enhancing recovery in this high-risk population.

Keywords: Acute myocardial infarction, Cardiac surgery, Coronary artery bypass grafting, Patch repair, Ventricular septal rupture

Received: February 27, 2025; Revised: May 16, 2025; Accepted: May 23, 2025; Prepublished online: June 2, 2012; Published: November 6, 2025  Show citation