Late Ischemic Ventricular Septal Defect

Author: Edward Verrier, MD
Institution: University of Washington
Date Reviewed: March 2014
Learning Domain: Adult Cardiac Surgery
Learning Objective: Complication of Coronary Artery Disease; Acquired Ventricular Septal Defect
PowerPoint File: Late Ischemic Ventricular Septal Defect

Discussion Points for Conference

• Is this a post infarction VSD?
• What is the natural history of post infarction VSD?
• What is the usual mortality from surgical repair of post MI Ventricular Septal defect
• Should repair of this Aneurysm / VSD have the same M & M as an acute Repair?  Why?
• How would you surgically approach this patient?

Learning Points

• Mortality and Morbidity of acute VSD after MI
  • Very high
• If pt survives early, late repair has significantly better prognosis
  • Self selection
  • Easier VSD repair with mature edges to sew into