Ventricular septal rupture after delayed STEMI: A modern management approach

Background: Myocardial infarction associated ventricular septal rupture (VSR) is a potentially catastrophic complication. Though surgical repair remains the definitive treatment, outcomes are poor with high mortality rates.Case and Management: We present the case of a 62‐year‐old male who presented with a delayed STEMI leading to a VSR and cardiogenic shock. His management strategy included early percutaneous VSR closure and use of an intra‐aortic balloon pump and inotropes. This served as a bridge to definitive surgical VSR patch repair while allowing hemodynamic stabilization, end‐organ recovery, and myocardial tissue stabilization.Conclusion: Mechanical support devices such as intra‐aortic balloon pump and Impella combined with percutaneous closure options can serve as a bridge to definitive surgery for VSR. This requires rapid mobilization of a multi‐disciplinary structural heart team including advanced imagers, structural interventionalists, and surgeons.