Abstract
Postinfarction ventricular septal rupture (VSR) remains a critical problem with significant morbidity and mortality despite recent advances in cardiovascular therapeutics. To rescue patients with VSR, it is necessary to diagnose them promptly and correctly, manage them appropriately, and perform complete and lasting repair. This review of VSR is updated with a discussion of the epidemiology, pathogenesis, diagnosis, novel management, and repair procedures from our perspective. Surgical repair continues to be the main procedure of choice, although it is associated with high mortality in the acute phase. Transcatheter closure plays a limited role. Mechanical circulatory support (MCS) devices have shown some promise in delaying closure, but the best practice has yet to be determined. Secure surgical VSR closure before a patient develops cardiogenic shock continues to provide the best clinical outcomes.
