[Infarct Exclusion Repair and Mitral Valve Replacement for Inferior Postinfarction Ventricular Septal Perforation].

We performed infarct exclusion repair of ventricular septal perforation(VSP) in a 63-year-old woman who was diagnosed with acute myocardial infarction(AMI) of the inferior wall. As VSP existed behind a fragile posterior papillary muscle, we excised the papillary muscle and sutured a bovine pericardial patch to exclude the infarct area of the whole septum and a part of the inferior wall. Mitral valve replacement and coronary artery bypass were also performed. The postoperative course was uneventful. There was no residual shunt and the left ventricular function was preserved. Selection of surgical procedures taking account of complete closure of VSP is important.