Spontaneous closure of residual ventricular septal defect following surgical repair of ventricular septal defect complicating acute myocardial infarction.

Spontaneous closure of ventricular septal defects in patients with congenital heart disease is well documented. Also, successful closure of ventricular septal defects complicating myocardial infarction performed in the acute phase have been reported, although the mortality rate is high. Intra-aortic balloon pumping has been helpful in this regard, as it was in our patient. Our case is of interest in that it demonstrates the possibility of spontaneous closure of a residual ventricular septal defect resulting from rupture of the interventricular septum, secondary to acute myocardial infarction, partially closed at surgery. Clearly, the residual defect was small in that the patient was substantially benefitted by surgery and the postoperative catheterization revealed a small 5% step-up in oxygen saturation at the right ventricular level.