[Surgical Technique for Massive Shunt after Repair of Post-infarction Ventricular Perforation].

We report a case of large anterior septal perforation (40×20 mm) immediately following repair of ventricular septal perforation( 9×9 mm) with the infarction exclusion technique. The large perforation was successfully repaired through a left ventriculotomy with a combined double patch/cone-shaped patch technique. This technique can be effective not only in cases of large laceration of ventricular septum as a consequence of inappropriate repair but also of large septal perforation with extensive fragility of the septal myocardium.