A Rare Case of Device Closure in a Patient with Residual Shunt Following Surgical Patch Repair for Ventricular Septal Rupture

The incidence of ventricular septal rupture (VSR) following ST elevation myocardial infarction has decreased from 1-3% in the pre-reperfusion era to 0.17-0.31% after the advent of primary percutaneous coronary intervention. Surgical repair is the definitive treatment strategy, but is associated with the highest mortality rates amongst all cardiac surgeries (42.9%). The incidence of a residual shunt is also very high (23.7% to 34%). There is often a dilemma in the management of patients with a significant residual shunt and a high risk for a second surgery. We report the case of a patient with post myocardial infarction VSR who had a significant residual shunt after surgical patch repair and was successfully treated by device closure.