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.