Introduction
With improvements in coronary revascularization, ventricular septal
defect (VSD) has become a rare mechanical complication of myocardial
infarction (MI). Mortality with conservative management remains over
94%, emphasizing the need for surgery1. The most
important determinant of survival is surgical timing, as there is a
graded decline in mortality with time and myocardial healing. Operative
mortality of VSD repair within 7 days of MI is 54.1% versus 18.4% if
surgery is performed after 7 days. When repair is delayed by over 21
days, mortality is reduced to 10%2. Strategies that
enable patient stabilization, allowing for optimal surgical timing are
necessary. We report two cases of post-MI VSD managed with a novel
approach using central extracorporeal membrane
oxygenation3 followed by patch repair.