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(Circulation. 1962;26:1321.)
© 1962 American Heart Association, Inc.

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Rupture of the Infarcted Interventricular Septum

Surgical Repair with Survival

ORVILLE W. BOICOURT M.D.¹; LEONARD W. RITZMANN M.D.¹; JOHN D. CHASE M.D.¹; ALBERT STARR M.D.¹; COLIN W. MCCORD M.D.¹

¹ From the Departments of Medicine and Surgery, University of Oregon Medical School, and the Departments of Medicine and Surgery, Veterans Administration Hospital, Portland, Oregon.

Successful surgical closure of a ruptured interventricular septum following myocardial infarction is reported. The patient developed the loud pansystolic parasternal murmur characteristic of septal perforation, and cardiac catheterization confirmed an unusually large left-to-right shunt. The patient's course was not the typical rapid deterioration with shock or intractable heart failure, but when myocardial insufficiency developed insidiously 5 weeks postinfarction, surgical closure with a Teflon patch was accomplished during cardiac bypass.

Since early death ensues so frequently, surgical repair has been attempted in only a small number of instances; this patient is one of the very few with successful closure and long-term survival. The pathology, clinical course, and cardiac catheterization data of this entity are reviewed from previously reported cases.