Surgical treatment of ventricular septal defect secondary to myocardial infarction.

13 patients were operated on during 1974-88 for ventricular septal defect secondary to myocardial infarction. 7 infarctions were inferior and 6 anterior. At the time of operation 5 patients were in shock. Besides the correction of ventricular septal defect coronary artery by-pass grafting was performed in 6 patients and left ventricular aneurysmectomy in 3 patients. The operative mortality was 31%. The cause of death was low output syndrome in 3 cases and a new rupture through the left ventricular free wall in one case. Postoperative shunting was detected in 5 patients. During an average follow-up time of 6.3 years (range 0.5-15 years) 3 patients died from a new myocardial infarction. The mean performance levels of the patients still living was NYHA II. Prompt diagnosis of a ventricular septal defect due to myocardial infarction and its immediate surgical treatment is recommended. The results are poor in the presence of primary shock and for inferior infarction.