CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1666868
This article is part of the Research TopicExploring New Frontiers in Heart Surgery: Case Studies 2025View all 17 articles
Case Report: Two Patch Technique with Bioglue Salvages a Patient with Acute Inferior Wall Myocardial Infarction Complicated by Ventricular Septal Rupture and Cardiogenic Shock
Provisionally accepted
- 1Division of Cardiology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, chiayi, Taiwan
- 2Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, chiayi, Taiwan
- 3Department of Cardiovascular Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, chiayi, Taiwan
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Post-myocardial infarction ventricular septal rupture (VSR) is a rare but often fatal complication of acute myocardial infarction (AMI). Without surgical or percutaneous intervention, mortality is exceedingly high. Even with corrective procedures such as surgical repair or transcatheter septal closure, in-hospital mortality remains substantial, particularly hemodynamically unstable patients. We report a case of acute inferior–posterior wall ST-segment elevation myocardial infarction complicated by a large VSR and cardiogenic shock. Immediate venoarterial extracorporeal membrane oxygenation (VA-ECMO) support was initiated. The patient subsequently underwent surgical repair using a modified infarct exclusion technique, in which BioGlue was applied between two patches to reinforce closure, and the second patch was extended into the ventriculotomy to simplify the procedure. The patient survived and remained free of recurrent VSR at 5-month follow-up. This modified approach offers a feasible and effective strategy for managing acute inferior– posterior VSR following AMI, particularly in critically ill patients.
Keywords: acute myocardial infarction, Ventricular Septal Rupture, Cardiogenic shock, post-infarction ventricular septal rupture, cardiac surgery
Received: 16 Jul 2025; Accepted: 19 Sep 2025.
Copyright: © 2025 Chang, Chen, Tsai and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rei-Yeuh Chang, changry77@gmail.com
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