2026, Number 3
Cir Card Mex 2026; 11 (3)
Post-myocardial infarction ventricular septal defect closure: does the end justify the means?
Orozco-Hernández, Erik J
ABSTRACT
Post-myocardial infarction ventricular septal defect (MI-VSD) remains one of the most catastrophic mechanical complications of acute coronary syndromes. It is characterized by a dismal natural history and an exceptionally high mortality rate, despite advances in reperfusion and critical care. While surgical repair persists as the definitive gold standard, one-year survival without intervention is exceedingly poor, and percutaneous alternatives have yielded only limited success. In clinical practice, the optimal timing and selection of candidates remain subjects of vigorous debate; although outcomes appear more favorable when delayed repair is feasible, surgical chronometry is frequently dictated by hemodynamic instability, necessitating high-risk emergent intervention.