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Ventricular septal rupture following myocardial infarction. Long-term survival of patients who did not undergo surgery. Single-centre experience.

Long-term survival is rare in patients not undergoing surgery after post-myocardial infarction ventricular septal rupture.We report our experience of seven patients out of 27, who did not undergo surgery and were followed up for a mean period of 2.8 years.They were evaluated after a mean period of 2.2 months after infarction in our centre. The septal defects measured 9.8 mms on average and the mean left-to-right shunt ratio was 1.98:1. The mean pulmonary artery, right atrial and left ventricular end diastolic pressures were 28.3 ± 10.6, 4 ± 3 and 15.8 ± 4.8 mm Hg, respectively. Only three out of seven patients had LV aneurysm and all patients had single-vessel disease. Smaller defect size, minimal left-to-right shunt and preserved right ventricular function may be the factors responsible for long-term survival.