Repair of postinfarction ventricular septal defect on a beating heart.

Two elderly patients with postinfarction ventricular septal defect underwent repair by endocardial patch with infarct exclusion on a beating heart under normothermic cardiopulmonary bypass with ultra-short-acting beta-blocker infusion. Their hemodynamic states soon recovered, and postoperative angiographic studies showed improvement of cardiac function and no residual shunt. Ultra-short-acting beta-blocker has the potential to facilitate safe repair of postinfarction ventricular septal defect on a beating heart, and this operative approach can be beneficial for myocardial protection.