With advances in the management of acute myocardial infarction (AMI) the incidence of mechanical complications continues to decline. Nevertheless, when they occur, unfortunately, despite similar advances and growing experiences in the surgical management of these problems, morbidity and mortality remain high. Post-myocardial infarction ventricular septal defects (PI-VSD) have fascinated and challenged clinicians for years. The timing of presentation can be quite variable, as they tend to occur in patients several days after their initial cardiovascular insult (acute PI-VSD) – and unfortunately, they can occur in patients who appear to have been making significance progress on the road to.
