Work

A Delayed Approach to Ventricular Septal Defect Repair After Myocardial Infarction

Year: 2025

Type: article

Abstract: BACKGROUND: A ventricular septal defect (VSD) is a rare but potentially fatal complication of myocardial infarction, with a mortality rate approaching 100% if managed conservatively. Patients typically present with cardiogenic shock, necessitating either percutaneous or surgical repair. However, the optimal timing of the repair remains unclear. CASE SUMMARY: We report the case of a 69-year-old male smoker with no comorbidities who developed an anterior wall ST-segment elevation myocardial infarction complicated by a VSD. He was initially managed conservatively. Four weeks later, he underwent coronary artery bypass grafting and surgical closure of the VSD. DISCUSSION: This delay contrasts with current guidelines (2013 ACCF/AHA; 2021 ACC consensus), which recommend urgent VSD closure after myocardial infarction. Surgery was deferred owing to the patient's stability, which permitted infarct maturation and reduced the risk of patch dehiscence. TAKE-HOME MESSAGE: In stable post-myocardial infarction VSD, individualized delayed surgery after optimal stabilization may yield excellent long-term outcomes.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105650

Authors: Saba Al Kindi, Adil Al-Jabri, Madan Mohan Maddali, Qasim Al Abri

Institution: Royal Hospital

Language: English

Topic: Cardiac Structural Anomalies and Repair

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850