title: [Late postinfarction rupture of the interventricular septum].
abstract: Postinfarction ventricular septal rupture complicates 1 to 2% of cases of acute myocardial infarction and accounts for 5% of early mortality. This severe complication usually occurs within two weeks after acute myocardial infarction, and the elderly are more susceptible. We present a case of late rupture of the septum.
  
  
  METHODS
  In a 75-year-old man, a ventricular septal defect developed more than two months after an extensive inferoseptal myocardial infarction due to occlusion of the right coronary artery. After more than two months of no symptoms he was referred to hospital due to symptoms of right ventricle failure. The diagnosis was made by echocardiography, pulmonary artery catheterization and ventriculography. Coronarography was also performed. Intraaortic balloon pump was introduced and the patient was transferred to the operating room. The defect was repaired using a circular polytetrafluoroethylene patch supported by buttressed interrupted sutures from both sides. Due to significant mitral valve regurgitation mechanical bileaflet mitral valve was implanted with preservation of the entire mitral apparatus and the left descending artery was revascularized using a saphenous graft.
  
  
  CONCLUSIONS
  This case is reported to emphasize that later postinfarction rupture of the ventricular septum may occur with symptoms of right ventricle failure dominating the clinical course.
authors: Zala Megyei Kórház, Szívsebészeti Osztály, Zalaegerszeg. arefino@zelkanet.hu
authors: Aref
authors: A
authors: Rashed
authors: András
authors: A
authors: Vígh
authors: Zoltán
authors: Z
authors: Németh
authors: Erzsébet
authors: E
authors: Feiler
authors: Nasri
authors: N
authors: Alotti
authors: József
authors: J
authors: Simon
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D006342:Heart Rupture, Post-Infarction; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery; D011138:Polytetrafluoroethylene; D018497:Ventricular Dysfunction, Right / Q000209:etiology*; D054088:Ventricular Septum
chemical_list: D011138:Polytetrafluoroethylene