Introduction
Ventricular septal rupture (VSR) is a rare complication of myocardial infarction that classically presents within one week of infarction1 as coagulation necrosis occurs within the infarcted tissue. Prior to the widespread use of reperfusion therapy, VSR was estimated to complicate between 1-3% of acute myocardial infarctions,2-4 whereas more recent estimates quote an incidence of 0.17%-0.34%.5,6 While uncommon, VSR carries a high risk of mortality when it occurs, estimated between 19-54% even with optimal treatment.2, 7-10
Although some controversy exists regarding the optimal timing of repair, surgical treatment remains the mainstay of therapy. Without surgical consultation and repair, blood flow is shunted from the high-pressure left ventricle (LV) into the low-pressure right ventricle (RV), resulting in RV overload, pulmonary congestion, and eventual biventricular failure. Herein we present a rare case in which VSR occurred during a cardiopulmonary bypass (CPB) run for urgent coronary artery bypass grafting (CABG).