Sequential rupture of the left ventricular free wall and of the interventricular septum after myocardial infarction. Surgical implications.

Two patients are reported in whom ventricular septal rupture complicated the recovery from surgery for left ventricular free wall rupture. One patient was successfully reoperated upon, but the second died before the diagnosis was obtained. The importance of being aware of the association and of excluding a left ventricular to right ventricular shunt at the time of surgery, or subsequently during clinical deterioration, is discussed.