POSTMYOCARDIAL INFARCTION VENTRICULAR SEPTAL-DEFECT - AN ANGIOGRAPHICSTUDY

Clinical and angiographic findings are reported in a consecutive serie s of nineteen patients with post infarction ventricular septal defect (PIVSD). In all patients PIVSD complicated a first myocardial infarct and none bad a history of angina pectoris prior to presentation. In ov er 50% of the patients PIVSD occurred within three days of infarction. The mean patient age was 65 years. Single vessel disease was noted in 63% of the patients. The mean left ventricular ejection fraction was 27%. Contrast left ventriculography localised the defect in all patien ts. Although a comprehensive cardiac ultrasound examination will gener ally confirm the diagnosis of PIVSD, preoperative coronary angiography is essential for the selection of those patients most likely to benef it from concomitant coronary artery bypass grafting at the time of sur gical repair of the interventricular septum.