CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 9, October 2012
e2
AFRICA
the cardiovascular surgery department.
An operation was decided on, with the consent of the
patient and family. He underwent successful coronary artery
bypass graft surgery and primary suturing of the VSR. He was
asymptomatic at follow-up visits.
Discussion
VSR is a life-threatening complication of acute myocardial
infarction (MI) requiring early intervention. It was common
(1–3%)
in the era before reperfusion therapy but has decreased
with the introduction of thrombolytic therapy and primary
Fig. 2A. A regurgitant jet is evident through the interventricular septum in the parasternal short-axis echocardio-
graphic view. B. A regurgitant jet is evident through the apical interventricular septum in the apical four-chamber axis
echocardiographic view. C. Ruptured apical interventricular septum and thinning apical wall is evident in a focused
apical four-chamber view. D. Ruptured apical interventricular septum, pseudoaneurysm and pericardial effusion is
seen in the apical four-chamber view.
A
C
B
D
Fig. 1B. Coronary angiography showing 95% stenosis in the middle and distal part of the left anterior descending
artery, thrombus in the proximal segment of the left anterior descending artery and non-critical stenosis in the circum-
flex artery. C. Non-critical stenosis in the right coronary artery.
B
C
