Ventricular septal defect and free wall rupture as mechanical complications of myocardial infarction: case reports

Introduction Mechanical complications of myocardial infarction (MI), such as free wall rupture (FWR) and post-myocardial infarction ventricular septal defect (post-MI VSD), are associated with a high mortality rate. In most cases, urgent surgical treatment is necessary. Aim This publication aims to present the surgical methods of treating post-MI VSD and chronic FWR. Case Study We present the case of a 74-year-old patient with post-MI VSD who underwent VSD closure using the Asai technique and a 59-year-old patient with chronic FWR and left ventricular pseudoaneurysm who underwent aneurysm resection and the Dor procedure for left ventricular reconstruction. Results and discussion The choice of optimal timing and treatment method depends on the damage type and the patient’s hemodynamic stability. Conclusions The treatment of choice is urgent cardiac surgery. In hemodynamically stable patients, deferred surgery may be performed to improve intraoperative conditions.