Ventricular Septal Rupture After Acute Myocardial Infarction-Do We Know Which Strategy to Choose?

Ventricular septal rupture is still a rare but often fatal complication of acute myocardial infarction. Emergent surgical closure of postinfarction ventricular septal rupture irrespective of the clinical status has been the standard treatment so far. A percutaneous approach using an occluder device is a less invasive option and allows immediate complete closure after initial hemodynamic stabilization. Furthermore immediate reduction of the left-to-right shunt, even if the ventricular septal rupture is not completely closed, may stabilize the patient enough to function as a bridge to surgery. We present two similar cases of patients which highlight the multiple features of acute myocardial infarction- related ventricular septal rupture treated with two alternative techniques.